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TOPLINE
Patients hospitalized for heart failure (HF) who were treated with intravenous loop diuretics and achieved a weight loss of at least 2 kg between admission and discharge had a reduced risk for HF rehospitalization within 30 days.
METHODOLOGY
- Researchers analyzed data from a Swedish registry to assess whether in-hospital weight loss in patients with HF who received intravenous loop diuretic therapy was associated with changes in biomarker levels and clinical outcomes.
- They included 4979 patients hospitalized for HF between 2017 and 2021 who received intravenous loop diuretics and survived to discharge; the median age was 80 years, and 57% were men.
- Weight loss was defined as a reduction of at least 2 kg between admission and discharge.
- The primary outcome was rehospitalization for HF. The secondary outcome was a composite of cardiovascular death or rehospitalization for HF at 30 days and 1 year; changes in biomarker levels were also measured.
TAKEAWAY
- The median weight change during hospitalization was -2.5 kg, and 59% of patients achieved a weight loss of at least 2 kg.
- A weight loss of at least 2 kg was independently associated with a lower risk for rehospitalization for HF (adjusted hazard ratio [aHR], 0.59; P < .001) and the composite of cardiovascular death or rehospitalization for HF (aHR, 0.76; P < .001) at 30 days. The protective associations did not persist beyond 30 days.
- Weight change showed no meaningful correlation with changes in the estimated glomerular filtration rate. The short-term association between weight loss and fewer 30-day outcomes was consistent across biomarker subgroups, including worsening renal function.
- Male patients; those with atrial fibrillation, obesity, or higher admission N-terminal pro-B-type natriuretic peptide levels; and those who used mineralocorticoid receptor antagonists were more likely to achieve weight loss.
IN PRACTICE
"Weight loss, reflecting decongestion, with intravenous loop diuretics was associated with reduced risk of re-HHF [HF hospitalization] in the short term consistent across biomarker changes, including eGFR [estimated glomerular filtration rate], during HHF," the researchers wrote.
SOURCE
The study was led by Mikael Erhardsson, MD, PhD, of Karolinska Institutet in Stockholm, Sweden. It was published online on August 25 in Heart.
LIMITATIONS
Weight loss was assumed to reflect the use of intravenous loop diuretics, but the effects of reduced eating and other diuretics were not assessed. The doses of intravenous loop diuretics were unavailable. The study was observational and could not establish a cause-effect relationship.
DISCLOSURES
The study was supported by a grant from the Swedish Heart and Lung Foundation. One author reported receiving support from several organizations, including the funding agency, and reported receiving consulting or speaker's honoraria from Medscape. Several authors reported receiving fees, research support, or honoraria or having consulting relationships with multiple companies. Detailed author disclosures are reported in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
