Methodology
The researchers analyzed data from the Swedish registry to determine whether in‑hospital weight loss in patients with heart failure who received intravenous therapy with loop diuretics is associated with changes in biomarker levels and clinical outcomes.
The study included 4,979 patients hospitalized with heart failure between 2017 and 2021, who received intravenous therapy with loop diuretics and survived until discharge. The average age of the patients was 80 years, and 57% of them were men.
Weight loss was defined as a reduction in body weight by at least 2 kg from the time of admission to the hospital until discharge.
The primary outcome was re‑hospitalization due to heart failure. The secondary outcome was the combination of cardiovascular death or re‑hospitalization due to heart failure within 30 days and 1 year. Changes in the levels of biomarkers were also measured.
Results
The median change in body weight during hospitalization was -2.5 kg, with 59% of patients losing at least 2 kg.
Weight loss of 2 kg or more was independently associated with a lower risk of rehospitalization for heart failure (adjusted risk ratio [RR] 0.59; P < 0.001) and a combination of cardiovascular death and rehospitalization for heart failure (RR 0.76; P < 0.001) within 30 days. The protective effect persisted only for 30 days.
Changes in body weight did not correlate with significant changes in estimated glomerular filtration rate. A short‑term association between weight loss and improved indicators within 30 days was observed in all subgroups based on biomarkers, including the subgroup with deteriorating kidney function.
Patients with atrial fibrillation, obesity, or elevated levels of N‑terminal pro‑B‑type natriuretic peptide at admission, as well as patients taking mineralocorticoid receptor antagonists, lost weight more frequently.
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