Key result
Significant weight loss (≥5%) in mild heart failure patients with CRT-D increased the risk of subsequent inappropriate ICD therapy compared to stable weight (HR 2.35; 95% CI 1.39-3.98; P=0.001).
Why the study?
Does significant weight loss increase the risk of inappropriate ICD therapy in mild heart failure patients receiving CRT-D?
Cohort (n=993)
Yes
Does significant weight loss increase the risk of inappropriate ICD therapy in mild heart failure patients receiving CRT-D?
In mild heart failure patients with a CRT-D, significant weight loss at 1 year is associated with a more than twofold increased risk of subsequent inappropriate ICD therapy.
Answers are grounded in this paper and cite their sources.
Weight loss may signal higher inappropriate ICD therapy risk in CRT-D patients; leaves open causality and need for prospective studies.
BACKGROUND: Weight loss has been associated with adverse outcomes among heart failure (HF) patients, including those receiving cardiac resynchronization therapy with defibrillator (CRT-D). The effect of significant weight change on inappropriate implantable cardioverter-defibrillator (ICD) therapy among CRT-D patients is not well understood. METHODS: We evaluated the impact of significant weight change at 1 year on subsequent inappropriate ICD therapy during follow-up among 993 CRT-D patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy. Patients were divided into three subgroups based on weight change at 1 year after enrollment: weight loss (weight loss ≥ 5%), weight gain (weight gain ≥ 5%), and stable weight (weight loss and weight gain < 5%). The primary end point was inappropriate ICD therapy. Secondary end point included inappropriate ICD therapy related to supraventricular arrhythmias (SVAs). RESULTS: There were 102 (10.3%) patients who experienced weight loss, 689 (69.4%) whose weight was stable, and 202 (20.3%) who gained weight at 1 year. Patients with weight loss had increased risk of subsequent inappropriate ICD therapy relative to patients with stable weight (hazard ratio [HR] = 2.35, 95% confidence interval [CI]: 1.39-3.98, P = 0.001) or weight gain (HR = 2.27, 95% CI: 1.18-4.38, P = 0.014). Furthermore, patients losing weight were at greater risk of subsequent inappropriate ICD therapy related to SVAs when compared to patients with stable weight (HR = 2.16, 95% CI: 1.18-3.95, P = 0.013) or weight gain (HR = 2.02, 95% CI: 0.95-4.29, P = 0.068). CONCLUSION: In mild HF patients receiving CRT-D, significant weight loss at 1 year is associated with increased risk of subsequent inappropriate ICD therapy, including risk related to SVAs.
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Daimee et al. (2016) conducted a cohort in Mild heart failure (n=993). Significant weight loss (≥ 5% at 1 year) vs. Stable weight (weight change < 5%) was evaluated on Inappropriate ICD therapy (HR 2.35, 95% CI 1.39-3.98, p=0.001). Significant weight loss (≥5%) in mild heart failure patients with CRT-D increased the risk of subsequent inappropriate ICD therapy compared to stable weight (HR 2.35; 95% CI 1.39-3.98; P=0.001).
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