A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

Minami-Takano, Asuka; Iwata, Hiroshi; Miyosawa, Katsutoshi; Kubota, K; Kimura, Atsushi; Osawa, Shota; Shitara, Minako; Okazaki, Shinya; Suwa, Satoru; Miyauchi, Katsumi; Sumiyoshi, Masataka; Amano, Atsushi; Daida, Hiroyuki

doi:10.3390/nu11061420

Cited by 15 publications

(23 citation statements)

References 30 publications

(40 reference statements)

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“…In 3567 patients who underwent percutaneous coronary intervention, TCBI was associated with a reduced all-cause, cardiovascular, and cancer mortality [7]. In hospitalized patients with critical cardiovascular disease using mechanical circulatory support devices, TCBI was an independent predictor of all-cause and cardiovascular mortality [8]. In both populations, they revealed a similar predictive value compared to GNRI.…”

Section: Discussionmentioning

confidence: 96%

“…The novel and simply calculated nutritional index, the TCB index (TCBI), calculated by multiplying serum triglycerides (TGs, mg/dL), serum total cholesterol (TC, mg/dL), and body weight (BW, kg) has been implicated as a useful prognostic indicator in patients with coronary artery disease and critically ill patients [7,8]. However, the association of TCBI with long-term outcomes in patients with ADHF has not been elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure

et al. 2020

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The TCB index (triglycerides × total cholesterol × body weight), a novel simply calculated nutritional index based on serum triglycerides (TGs), serum total cholesterol (TC), and body weight (BW), was recently reported to be a useful prognostic indicator in patients with coronary artery disease. Thus, this study aimed to investigate the relationship between TCBI and long-term mortality in acute decompensated heart failure (ADHF) patients. Patients with a diagnosis of ADHF who were consecutively admitted to the cardiac intensive care unit in our institution from 2007 to 2011 were targeted. TCBI was calculated using the formula TG (mg/dL) × TC (mg/dL) × BW (kg)/1000. Patients were divided into two groups according to the median TCBI value. An association between admission TCBI and mortality was assessed using univariable and multivariable Cox proportional hazard analyses. Overall, 417 eligible patients were enrolled, and 94 (22.5%) patients died during a median follow-up period of 2.2 years. The cumulative survival rate with respect to all-cause, cardiovascular, and cancer-related mortalities was worse in patients with low TCBI than in those with high TCBI. In the multivariable analysis, although TCBI was not associated with cardiovascular and cancer mortalities, the association between TCBI and reduced all-cause mortality (hazard ratio: 0.64, 95% confidence interval: 0.44–0.94, p = 0.024) was observed. We computed net reclassification improvement (NRI) when TCBI or Geriatric Nutritional Risk Index (GNRI) was added on established predictors such as hemoglobin, serum sodium level, and both. TCBI improved discrimination for all-cause mortality (NRI: 0.42, p < 0.001; when added on hemoglobin and serum sodium level). GNRI can improve discrimination for cancer mortality (NRI: 0.96, p = 0.002; when added on hemoglobin and serum sodium level). TCBI, a novel and simply calculated nutritional index, can be useful to stratify patients with ADHF who were at risk for worse long-term overall mortality.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure

et al. 2020

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“…Therefore, TCBI is considered to be a useful prognostic indicator in CAD patients [ 9 ]. Moreover, it may also be a valuable indicator in patients with a critical and hemodynamically unstable cardiovascular disease requiring percutaneously implantable mechanical circulatory support devices [ 14 ]. Unlike the GNRI, the TCBI comprises general examination variables relevant to patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

Impact of nutritional index on long-term outcomes of elderly patients with coronary artery disease: sub-analysis of the SHINANO 5 year registry

et al. 2020

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Nutritional status is a novel approach to prognostic assessment in patients with cardiovascular disease. However, assessment of nutritional status in elderly patients is challenging due to the significant differences between young patients. The TCBI (Triglycerides × Total cholesterol × Body Weight Index) is a novel and simple nutritional index for predicting long-term outcomes in patients with coronary artery disease. This retrospective study evaluated the efficacy of TCBI in 597 elderly (≥ 75 years) patients enrolled in the SHINANO 5 year registry. The SHINANO 5 year registry, a prospective observational multicenter cohort study, had enrolled 1501 consecutive patients who underwent elective/urgent percutaneous coronary intervention (PCI). In this study, patients were categorized into TCBI quartile groups. The primary endpoints were the occurrence of major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, stroke, and myocardial infarction at 5 year. The mean duration of follow up was 4.3 ± 1.7 years. The average patient age was 80.9 ± 4.3 years. MACCE was observed in 61 (40.9%) patients in the lowest TCBI quartile group. Kaplan–Meier analysis demonstrated an inverse relationship between MACCE and TCBI (log-lank P < 0.001). Multivariate analysis demonstrated that low TCBI significantly predicted the incidence of MACCE (hazard ratio: 1.44, 95% confidence interval: 1.03–2.00; P = 0.031). The TCBI is useful in predicting long-term outcomes in elderly patients undergoing PCI.

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“…In recent years, TCBI has been shown to be associated with HF outcomes. In hospitalized critical patients with mechanical circulatory support devices, TCBI was an independent predictor of all-cause mortality ( Minami-Takano et al, 2019 ). In patients with acute decompensated heart failure, TCBI can improve the prognostic prediction over traditional risk factors such as hemoglobin and serum sodium level ( Ishiwata et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Some simplified nutritional screening tools such as the Geriatric Nutritional Risk Index (GNRI), the prognostic nutritional index (PNI), and the Controlling Nutritional Status (CONUT), have been found to predict the outcome of heart failure ( Lin et al, 2016 ). Recently, a novel nutritional index, triglycerides × total cholesterol × body weight index (TCBI), has been proposed to be a useful prognostic indicator in patients with CAD ( Doi et al, 2018 ; Kim et al, 2021 ), acute decompensated heart failure ( Ishiwata et al, 2020 ), and critically ill patients ( Minami-Takano et al, 2019 ). However, in patients with DCM, the prognostic value of TCBI has not yet been studied.…”

Section: Introductionmentioning

confidence: 99%

A novel nutritional index as a predictor of mortality in dilated cardiomyopathy: a retrospective study

Wang

Qing

Chen

et al. 2022

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Background Research has associated nutritional status with the prognosis of cardiovascular diseases. This study aimed to investigate the prognostic value of a novel nutritional index, triglycerides × total cholesterol × body weight index (TCBI), in patients with dilated cardiomyopathy (DCM). Methods This retrospective cohort study enrolled 445 patients with DCM. The median follow-up period was 2.8 years, and the primary endpoint was all-cause death. Results During follow-up, the all-cause mortality was observed in 135 out of 445 patients (30.3%). In Kaplan–Meier survival analysis, the third TCBI tertile had a lower mortality risk (T3 vs. T2 vs. T1: 16.9% vs. 35.1% vs. 38.9%; log-rank P < 0.001). In the multivariable Cox regression analysis, patients in the third tertile were associated with a decreased mortality, whereas there was no significant difference between the T2 and T1 groups. Moreover, TCBI could significantly improve risk stratification (continuous net reclassification improvement and integrated discrimination improvement) over the Geriatric Nutritional Risk Index (GNRI) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Conclusions TCBI is independently associated with long-term survival in patients with DCM. Combination of TCBI and other biomarkers, such as GNRI and NT-proBNP, can significantly improve prognostic prediction. Further studies with larger sample size are required to validate our results.

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A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support

Cited by 15 publications

References 30 publications

Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure

Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure

Impact of nutritional index on long-term outcomes of elderly patients with coronary artery disease: sub-analysis of the SHINANO 5 year registry

A novel nutritional index as a predictor of mortality in dilated cardiomyopathy: a retrospective study

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