Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors

An observational study

Stefan D. Anker, Abdissa Negassa, Andrew J S Coats, Rizwan Afzal, Philip A. Poole-Wilson, Jay N. Cohn, Salim Yusuf

Research output: Contribution to journalArticle

484 Citations (Scopus)

Abstract

Background. Weight loss in chronic heart failure is linked to impaired survival. We aimed to assess the frequency of weight loss in patients with this disease, whether the degree of weight loss predicts mortality, and whether weight loss can be prevented by angiotensin-converting-enzyme (ACE) inhibitors. Methods. We investigated weight changes in 1929 patients from the SOLVD trial who had chronic heart failure, were free of oedema at baseline, and survived for at least 4 months after trial entry. Mean follow-up was 35 months (SD 13). We analysed the effect of weight loss at cutpoints of 5%, 7·5%, 10%, 15% (a priori), and 6% (post hoc) to identify which one best predicted outcome. To validate results, we analysed data for 619 patients in the V-HeFT II trial. Findings. 817 (42%) patients in the SOLVD trial had weight loss from baseline of 5% or more. At 8 months follow-up, all cutpoints for weight loss were significantly associated with impaired survival after adjustment for age, sex, New York Heart Association class, left ventricular ejection fraction, and treatment allocation. Weight loss of 6% or more at any time during follow-up was the strongest predictor of impaired survival (adjusted hazard ratio 2·10, 95% CI 1·77-2·49; p

Original languageEnglish
Pages (from-to)1077-1083
Number of pages7
JournalLancet
Volume361
Issue number9363
DOIs
Publication statusPublished - Mar 29 2003

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Angiotensin-Converting Enzyme Inhibitors
Observational Studies
Weight Loss
Heart Failure
Therapeutics
Survival
Stroke Volume
Edema
Weights and Measures
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors : An observational study. / Anker, Stefan D.; Negassa, Abdissa; Coats, Andrew J S; Afzal, Rizwan; Poole-Wilson, Philip A.; Cohn, Jay N.; Yusuf, Salim.

In: Lancet, Vol. 361, No. 9363, 29.03.2003, p. 1077-1083.

Research output: Contribution to journalArticle

Anker, Stefan D. ; Negassa, Abdissa ; Coats, Andrew J S ; Afzal, Rizwan ; Poole-Wilson, Philip A. ; Cohn, Jay N. ; Yusuf, Salim. / Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors : An observational study. In: Lancet. 2003 ; Vol. 361, No. 9363. pp. 1077-1083.
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