Weight Change and Mortality Risk in Heart Failure With Preserved Ejection Fraction

Peisen Huang, Zejun Guo, Weihao Liang, Yuzhong Wu, Jingjing Zhao, Xin He, Wengen Zhu, Chen Liu, Yugang Dong, Yuan Yu, Bin Dong, Peisen Huang, Zejun Guo, Weihao Liang, Yuzhong Wu, Jingjing Zhao, Xin He, Wengen Zhu, Chen Liu, Yugang Dong, Yuan Yu, Bin Dong

Abstract

Aims: The aim of the study was to determine the associations of weight loss or gain with all-cause mortality risk in heart failure with preserved ejection fraction (HFpEF). Methods and Results: Non-lean patients from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist study were analyzed (n = 1,515). Weight loss and weight gain were defined as a decrease or increase in weight ≥5% between baseline and 1 year. To determine the associations of weight change and mortality risk, we used adjusted Cox proportional hazards models and restricted cubic spline models. The mean age was 71.5 (9.6) years. Weight loss and gain were witnessed in 19.3 and 15.9% patients, respectively. After multivariable adjustment, weight loss was associated with higher risk of mortality (HR 1.42, 95% CI 1.06-1.89, P = 0.002); weight gain had similar risk of mortality (HR 0.98, 95% CI 0.68-1.42, P = 0.932) compared with weight stability. There was linear relationship between weight change and mortality risk. The association of weight loss and mortality was different for patients with and without diabetes mellitus (interaction p = 0.009). Conclusion: Among patients with HFpEF, weight loss was independently associated with higher risk of all-cause mortality, and weight gain was not associated with better survival. Clinical Trial Registration: https://ichgcp.net/clinical-trials-registry/NCT00094302" title="See in ClinicalTrials.gov">NCT00094302.

Keywords: HFpEF; heart failure; mortality; weight gain; weight loss.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Huang, Guo, Liang, Wu, Zhao, He, Zhu, Liu, Dong, Yu and Dong.

Figures

Figure 1
Figure 1
Restricted cubic spline plots for all-cause mortality by weight change. A positive value means increased weight, and a negative value means decreased weight.
Figure 2
Figure 2
Multivariable Cox regression analysis for various subgroups. BMI, body mass index.

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