Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
PLoS One. 2023 Jun 23;18(6):e0287637. doi: 10.1371/journal.pone.0287637. eCollection 2023.
The prognostic implication of weight loss after discharge from acute heart failure (AHF) remains unclear. We sought to investigate the association of weight loss between discharge and 6-month visit with subsequent clinical outcomes in patients with AHF.
We analyzed 686 patients with AHF in the prospective longitudinal follow-up study derived from the Kyoto Congestive Heart Failure registry, and divided them into 2 groups based on the weight loss at 6-month index visit. We defined the weight loss as ≥ 5% decrease in body weight from discharge to 6-month index visit.
There were 90 patients (13.1%) with a weight loss at 6-month visit. Patients in the weight loss group compared with those in the no weight loss group had higher body weight at discharge and lower body weight at 6-mont visit. Patients in the weight loss group had a lower systolic blood pressure, higher brain-type natriuretic peptide, lower serum albumin, lower hemoglobin, higher prevalence of heart failure with reduced ejection fraction at 6-month visit, and a lower prescription rate of inhibitors of renin-angiotensin system than those in the no weight loss group. The cumulative 6-month incidence of all-cause death was significantly higher in the weight loss group than in the no weight loss group (14.2% and 4.3%, log-rank P<0.001). The excess adjusted risk of the weight loss group relative to the no weight loss group remained significant for all-cause death (HR 2.39, 95%CI 1.01-5.65, P = 0.048).
Body weight loss of ≥5% at 6-month visit after discharge was associated with subsequent all-cause death in patients with AHF.
急性心力衰竭（AHF）出院后体重减轻的预后意义尚不清楚。我们旨在研究 AHF 患者出院至 6 个月就诊期间的体重减轻与随后临床结局的关系。
我们分析了前瞻性纵向随访研究中来自京都充血性心力衰竭注册中心的 686 例 AHF 患者，并根据 6 个月指数就诊时的体重减轻将其分为 2 组。我们将体重减轻定义为从出院到 6 个月指数就诊时体重下降≥5%。
有 90 例患者（13.1%）在 6 个月就诊时体重减轻。与无体重减轻组相比，体重减轻组患者出院时体重较高，6 个月就诊时体重较低。体重减轻组患者收缩压较低，脑利钠肽较高，血清白蛋白较低，血红蛋白较低，6 个月就诊时心力衰竭射血分数降低的发生率较高，肾素-血管紧张素系统抑制剂的处方率较低。体重减轻组的累积 6 个月全因死亡率明显高于无体重减轻组（14.2%和 4.3%，对数秩 P<0.001）。与无体重减轻组相比，体重减轻组发生全因死亡的风险明显增加（HR 2.39，95%CI 1.01-5.65，P=0.048）。
出院后 6 个月就诊时体重减轻≥5%与 AHF 患者随后的全因死亡相关。
