Abstract 17439: Prognostic Impact of Body Weight Change in Patients With Chronic Heart Failure: Data From Gissi-Hf Trial
Background: The favorable prognostic role of body weight reduction in unselected populations and in patients with coronary artery disease is well defined. However, the association between weight change and prognosis in patients with chronic heart failure (HF) is still debated.
Methods: Adjusted Cox’s regression models, with all-cause mortality, death for HF worsening and fatal and non-fatal myocardial infarction as outcomes were fitted in 6,037 HF patients enrolled in GISSI-HF trial with valid values for weight at baseline and at the 6-month visit. Weight change was defined as the difference between weight assessed at 6-month and at baseline. Outcome events were included in the analysis if they were recorded from 6 months to the end of the study.
Results: Weight change during the first 6 months of follow-up was significantly associated with all-cause mortality. As compared with patients who had a body weight decrement <5% [n=3009 (49.8%), reference category], the risk of all-cause mortality was increased in patients with a moderate [n=345 (5.7%); HR: 1.422, 95% CI: 1.168-1.730, p<0.01] or severe [n=116 (1.9%); HR: 1.363, 95% CI: 0.992-1.873, p=0.056] weight decrease and in patients with a severe weight increase [n=182 (3%), HR: 1.404, 95% CI: 1.066-1.849, p=0.016]. A similar, though non-significant association was observed for death due to HF worsening and for fatal and non-fatal myocardial infarction.
Conclusions: Substantial weight changes, potentially reflecting worsening of oedemigen status or incipient cachexia, are associated with reduced survival in patients with HF.
- © 2013 by American Heart Association, Inc.