Association of weight change with subsequent outcomes in patients hospitalized with acute decompensated heart failure.
Association of weight change with subsequent outcomes in patients hospitalized with acute decompensated heart failure.
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DOI：
10.1016/j.amjcard.2008.08.041
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
O'Connor, Christopher M.
中科院分区：
文献类型：
--
作者：
Mehta, Rajendra H.;Rogers, Joseph G.;Hasselblad, Vic;Tasissa, Gudaye;Binanay, Cynthia;Califf, Robert M.;O'Connor, Christopher M.
在急性失代偿性心力衰竭（HF）患者中，通过各种减氧策略实现的体重减轻与临床结果的关系尚未得到很好的描述。我们的目的是确定失代偿期HF患者住院期间体重变化与随后临床事件之间的关系。我们评估了433名参加充血性心力衰竭和肺动脉导管置入有效性评估研究（ESCAPE）试验的晚期HF住院患者的数据。评估住院期间体重变化对临床结果（前6个月出院存活天数；死亡；死亡或再住院；死亡、再住院或心脏移植）的影响。患者在住院期间平均减重约3.6公斤。当被分为3组时，最高组更可能是年龄较大、女性、吸烟者、体重较高、既往经皮冠状动脉介入治疗、基线心率、BNP和尿素氮值，但射血分数和峰值耗氧量较低。体重变化与任何住院或随访事件之间无显著差异（入院天数HR 0.995 [95% CI 0.975-1.016]； 180天死亡HR 1.012 [95% CI 0.969-1.057]； 180天死亡/再住院HR 1.014 [95% CI 0.990-1.038]）。综上所述，急性失代偿性心衰患者住院期间体重减轻与临床终点无关。这些数据挑战了在随机对照临床试验中使用体重作为更重要的临床事件（如心力衰竭患者死亡和/或再住院）治疗策略设计中的替代终点的优点。
Association of weight loss achieved through various decongestive strategies with clinical outcomes in acute decompensated heart failure (HF) patients is not well described. Our goal was to determine the relationship between weight change during hospitalization and subsequent clinical events in decompensated HF patients. We evaluated data on 433 patients hospitalized with advanced HF enrolled in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial. The influence of change in weight during hospitalization to clinical outcomes (days alive out of hospital in the first 6 months; death; death or rehospitalization; and death, rehospitalization or cardiac transplantation) was evaluated. On average patients lost approximately 3.6 Kg during hospitalization. When categorized into 3 weight loss tertiles, those in highest tertile were more likely to be older, females, smokers, with higher body weight, prior percutaneous coronary intervention(s), baseline heart rate, and BNP and blood urea nitrogen values, but lower ejection fraction and peak oxygen consumptions. No significant differences were observed between weight change and any in-hospital or follow-up events (days well HR 0.995 [95% CI 0.975–1.016]; 180 days death HR 1.012 [95% CI 0.969–1.057]; death/rehospitalization-180 days HR 1.014 [95% CI 0.990–1.038]). In conclusions, weight loss in patients with acute decompensated HF during hospitalization was not related to clinical end-points. This data challenges the merit of using weight as a surrogate endpoint for more important clinical events i.e. death and/or rehospitalization in patients with heart failure in the design of treatment strategies for novel therapeutic agents in randomized controlled clinical trials.
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影响因子：
6.1
作者：
FORSLUND, T;RIDDERVOLD, F;SIMONSEN, S
通讯作者：
SIMONSEN, S
影响因子：
5.9
作者：
AGOSTONI, P;MARENZI, G;GUAZZI, MD
通讯作者：
GUAZZI, MD
影响因子：
24
作者：
Costanzo, Maria Rosa;Guglin, Maya E.;Sobotka, Paul A.
通讯作者：
Sobotka, Paul A.
影响因子：
120.7
作者：
Konstam, Marvin A.;Gheorghiade, Mihai;Orlandi, Cesare
通讯作者：
Orlandi, Cesare
DOI：
10.1016/0735-1097(93)90685-t
发表时间：
1993-02-01
影响因子：
24
作者：
AGOSTONI, PG;MARENZI, GC;GUAZZI, MD
通讯作者：
GUAZZI, MD