Weight monitoring in patients with severe heart failure (WISH). A randomized controlled trial

Abstract

Aims: This multicentre, randomized controlled trial hypothesized that daily electronic transmission of body weight to a heart failure (HF) clinic will reduce cardiac hospitalization in patients recently hospitalized with HF.

Methods and results: A total of 344 patients were randomized to either an intervention group (IG) or a control group (CG). Of the 319 patients included in the final analysis, the mean age was 73 years (SD 10.2), 75% were males, and 57% had a left ventricular ejection fraction (LVEF) <30%. Patients in both groups were recommended to weigh themselves daily and, in the case of sudden weight gain >2 kg in 3 days, to contact the HF clinic. Patients in the IG were given an electronic scale and the weight was automatically transmitted to and monitored at the HF clinic. No significant differences were found for the primary endpoint, cardiac re-hospitalization [70/153 CG, 70/166 IG; hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.65-1.26, P = 0.54], or for the secondary endpoints, which included all-cause hospitalization (84/153 CG, 79/166 IG; HR 0.83, 95% CI 0.61-1.13, P = 0.24), death from any cause (8/153 CG, 5/166 IG; HR 0.57, 95% CI 0.19-1.73, P = 0.32), or the composite endpoint of cardiac hospitalization and death from any cause (78/153 CG, 75/166 IG; HR 0.90, 95% CI 0.65-1.26, P = 0.54). Subgroup analyses did not show any benefits for patients in the IG despite their more frequent monitoring; 398 occasions compared with 30 occasions in the CG.

Conclusion: Daily electronic transmission of body weight and monitoring three times a week did not decrease hospitalization or death in HF patients followed up at a HF clinic.