Appetite Predicts Clinical Outcomes in High Risk Patients Undergoing Trans-Femoral TAVI

Abstract

Transcatheter aortic valve implantation (TAVI) has been recognized as a standard therapy for severe aortic valve stenosis. However, since some patients who receive TAVI have poor outcomes, the predictors of clinical outcomes after TAVI are important. The aim of this study was to investigate the association between appetite and long-term clinical outcomes. We screened consecutive cases who received TAVI at our medical center between July 2014 and October 2018. A total of 139 patients who received transfemoral TAVI were included as the final study population. They were divided into a good appetite group (n = 105) and a less appetite group (n = 34) according to their dietary intake rate (> 90%: good appetite group, !90%: less appetite group). We defined the intake rate as the average for breakfast, lunch, and dinner on the day just before discharge. We defined two-year major adverse cardiovascular and cerebrovascular events (MACCE) as a composite of cardiovascular death, myocardial infarction, any coronary revascularization, history of hospitalization due to heart failure, and disabling acute cerebral infarction. Kaplan-Meier analyses and multivariate Cox regression analysis were performed. The median duration of the follow-up period was 372 (189-720) days. Kaplan-Meier curves showed that the less appetite group got MACCE more frequently (event free rate of the less appetite group: 76.5% versus the good appetite group: 94.3%, Log Rank P = 0.01). In multivariate Cox regression analysis, having less appetite was a significant predictor of two-year MACCE (HR 5.26, 95%CI 1.66-16.71, P < 0.01). In conclusion, among the patients who received transfemoral TAVI, appetite status just before discharge was significantly associated with long-term outcome.

A Nomogram based on a Patient-reported Outcomes Measure: Predicting the Risk of Readmission for Patients with Chronic Heart Failure

“…[33] Moreover, anxiety, appetite and sleep were confirmed to be predictors of readmission for CHF in retrospective studies, which may have been impacted by the fact that the patient's status influences the risk of readmission. [34][35][36][37] Kitamura M not only confirmed that daily activities were independent predictors of readmission in heart failure patients within 90 days, but also calculated the cut-off value by ROC curve [38] and the study have also proved that self-care and daily activities are the mediating factors of readmission of heart failure. [39] While Hochang Benjamin Lee et al emphasized that personality disorders as predictors of incident cardiovascular disease increased risk disease, [40] our results are quite the opposite, which may be because the subjects studied were different; Apart from the results on patient paranoia, these findings were similar to the results of our reports on the readmission risk factors for CHF.…”

A nomogram based on a patient-reported outcomes measure: predicting the risk of readmission for patients with chronic heart failure

“…Staniute et al further also demonstrated that anxiety, depression and social support can indirectly affect the quality of life of patients with HF [38]. Moreover, anxiety, appetite and sleep were confirmed to be predictors of readmission for CHF in retrospective studies, which may have been impacted by the fact that the patient's status influences the risk of readmission [39][40][41][42]. Kitamura M not only confirmed that daily activities were independent predictors of readmission in heart failure patients within 90 days, but also calculated the cutoff value by ROC curve [43] and the study have also proved that self-care and daily activities are the mediating factors of readmission of heart failure [44].…”

A Nomogram based on a Patient-reported Outcomes Measure: Predicting the Risk of Readmission for Patients with Chronic Heart Failure

“…[38] Moreover, anxiety, appetite and sleep were con rmed to be predictors of readmission for CHF in retrospective studies, which may have been impacted by the fact that the patient's status in uences the risk of readmission. [39][40][41][42] Kitamura M not only con rmed that daily activities were independent predictors of readmission in heart failure patients within 90 days, but also calculated the cut-off value by ROC curve [43] and the study have also proved that self-care and daily activities are the mediating factors of readmission of heart failure. [44] While Hochang Benjamin Lee et al emphasized that personality disorders as predictors of incident cardiovascular disease increased risk disease, [45] our results are quite the opposite, which may be because the subjects studied were different; Apart from the results on patient paranoia, these ndings were similar to the results of our reports on the readmission risk factors for CHF.…”