Weight changes after hospitalization for worsening heart failure and subsequent re-hospitalization and mortality in the EVEREST trial.
OBJECTIVE
Increases in body weight (BW) are important determinants for hospitalization in ambulatory patients with heart failure (HF), but have not yet been explored in patients hospitalized for worsening HF. We explore the relationship between change in BW after hospitalization for worsening HF and risk for repeat hospitalization and mortality in the EVEREST trial.


RESULTS
The EVEREST trial randomized 4133 patients hospitalized for worsening HF and low ejection fraction (< or =40%) to tolvaptan, a vasopressin antagonist, or placebo. Following discharge, BW was assessed at 1, 4, and 8 weeks, and every 8 weeks thereafter. A time-dependent Cox proportional Hazard model explored the relationship between change in BW at 60, 120, and 180 days from discharge and the risks of HF hospitalization, cardiovascular (CV) hospitalization, and all-cause mortality. For subjects re-hospitalized for heart failure at 60, 120, and 180 days after discharge, mean BW increase prior to the event was 1.96, 2.07, and 1.97 kg, respectively, compared with 0.74, 0.90, and 1.04 kg in patients without re-hospitalization (P < 0.001 all groups). A similar pattern was observed with CV hospitalization. However, increases in BW were not predictive of all-cause mortality.


CONCLUSIONS
Increases in BW after hospitalization for worsening HF was predictive of repeat hospitalization events, but not mortality in the post-discharge period.
Division of Cardiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Suite 600, Chicago, IL 60611, USA.
John E A
JE
Blair
Sadiya
S
Khan
Marvin A
MA
Konstam
Karl
K
Swedberg
Faiez
F
Zannad
John C
JC
Burnett
Liliana
L
Grinfeld
Aldo P
AP
Maggioni
James E
JE
Udelson
Christopher A
CA
Zimmer
John
J
Ouyang
Chien-Feng
CF
Chen
Mihai
M
Gheorghiade
D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines / Q000627:therapeutic use; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011379:Prognosis; D000077602:Tolvaptan; D016896:Treatment Outcome; D015430:Weight Gain
D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan