Key result
High post-heart transplantation weight gain was independently associated with a 3.5-fold increased risk for cardiac allograft vasculopathy (95% CI 1.4-8.7, p=0.01) and a 4.2-fold risk for rejection.
Why the study?
Because fat mass and fat-free mass both contribute to total body weight, researchers sought to characterize post-heart transplantation changes in total body weight and their implications for outcomes.
Does high weight gain post-heart transplantation increase the risk of cardiac allograft vasculopathy and rejection in heart transplant recipients?
Cohort (n=211)
Does high weight gain post-heart transplantation increase the risk of cardiac allograft vasculopathy and rejection in heart transplant recipients?
Hazard Ratio: 3.5 (95% CI 1.4–8.7)
p-value: p=0.01
Significant weight gain, primarily from fat mass, after heart transplantation is independently associated with a markedly increased risk of cardiac allograft vasculopathy and rejection.
Post-HT TBW gain warrants body-composition monitoring; leaves open independent links to CAV or rejection.
OBJECTIVE: Obesity and overweight are associated with an increased risk for cardiovascular disease. Since fat mass (FM) and fat-free mass (FFM) both contribute to total body weight (TBW), we characterized the post-heart transplantation (HT) change in TBW and its implications for outcomes. METHODS: Post-HT changes in TBW, FM, and FFM were reviewed for 211 HT patients assessed during 1997-2017. Endpoints included cardiac allograft vasculopathy (CAV) and rejection. RESULTS: Median TBW increased by 7.3% at 1 year, with a significant rise in the obese category (28% vs. 13%, p < 0.001) and with FM versus FFM making the main contribution (23% vs. 3%, p < 0.001). When patients were divided according to median TBW change ("high" vs. "low"), Kaplan-Meier analysis showed that 10-year freedom from CAV (log-rank p < 0.005) and rejection (log-rank p < 0.01) was significantly higher for the "low" TBW change group. Consistently, multivariable analyses showed that the "high" group was independently associated with significant 3.5-fold and 4.2-fold increased risks for CAV (95% CI 1.4-8.7, p = 0.01) and rejection (95% CI 1.2-15.4, p = 0.03), respectively. CONCLUSIONS: Weight gain, contributed mostly by FM, is independently associated with an increased risk for CAV and rejection. Follow-up emphasis should be placed on weight gain and preventative measures.
No takes yet. Share an insight, caveat, or question.
Ram et al. (2020) conducted a cohort in Heart transplantation (n=211). High total body weight change (weight gain) vs. Low total body weight change was evaluated on Cardiac allograft vasculopathy (CAV) (HR 3.5, 95% CI 1.4-8.7, p=0.01). High post-heart transplantation weight gain was independently associated with a 3.5-fold increased risk for cardiac allograft vasculopathy (95% CI 1.4-8.7, p=0.01) and a 4.2-fold risk for rejection.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: