Geriatric Nutritional Risk Index Predicts Functional Dependency and Mortality in Patients With Heart Failure With Preserved Ejection Fraction

Sung

et al. 2017

JAHA

204

208

BackgroundNutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure.Methods and ResultsA total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm3). National Death Registry was linked to identify the clinical outcomes of all‐cause and cardiovascular death. With increasing tertiles of PNI, age and N‐terminal probrain natriuretic peptide decreased, and body mass index, estimated glomerular filtration rate, and hemoglobin increased. During a mean follow‐up duration of 31.5 months, a higher PNI tertile was related to better survival free from all‐cause and cardiovascular mortality in the total study population and in participants with either reduced or preserved left ventricular ejection fraction. After accounting for age, sex, estimated glomerular filtration rate, left ventricular ejection fraction, serum sodium level, and on‐admission systolic blood pressure, PNI was independently associated with cardiovascular death and total mortality (hazard ratio per 1 SD of the natural logarithm of the PNI: 0.76 [95% CI, 0.66–0.87] and 0.79 [95% CI, 0.73–0.87], respectively). In subgroup analyses stratified by age, sex, left ventricular ejection fraction, body mass index, or estimated glomerular filtration rate, PNI was consistently related to mortality.Conclusions PNI is independently associated with long‐term survival in patients hospitalized for acute heart failure with either reduced or preserved left ventricular ejection fraction.

Section: Discussionmentioning

confidence: 49%

Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure

Sung

et al. 2017

JAHA

204

208

“…Nutritional evaluation: Serum TTR concentrations, serum albumin, peripheral blood total lymphocyte counts, and total cholesterol were measured on admission as serum markers associated with nutritional status, and all parameters were assessed using the MNA ® , 19) CONUT, 4,17) and GNRI 18,20) nutritional assessment tools.…”

Section: )mentioning

confidence: 99%

“…18,20) All nutritional assessments were performed within 48 hours of hospitalization. Echocardiography: All echocardiographic measurements were obtained using a commercially available sector scanner (Aplio ® , Toshiba, Tokyo) by 3 experienced technicians who were blinded to the study details.…”

Section: )mentioning

confidence: 99%

“…Patients with LVEF ≥ 40% were classified as HF preserved LVEF (HFpEF) and patients with LVEF < 40% were classified as HF with reduced LVEF (HFrEF). 20,23,24) Outcomes: The primary endpoint was all cause death or readmission due to worsening HF during the observation period, which was defined as an "event". Statistics: The quantitative data obtained are expressed as the mean ± standard deviation.…”

Section: )mentioning

confidence: 99%

“…Many studies have reported their usefulness in predicting the prognosis in patients with HF. 4,5,15,20,21) Bonilla, et al 5) assessed patients with chronic HF according to the MNA ® and found that 12.8% of patients were malnourished and 60.2% of patients were at risk of malnutrition, while only 27.0% had normal nutritional status. "At risk of malnutrition" includes the possibility of malnutrition that is necessary to be extracted.…”

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confidence: 99%

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Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

et al. 2015

SummaryDecreased Transthyretin (TTR) can be observed in heart failure patients with malnutrition evaluated by the Mini Nutritional Assessment (MNA). This study investigated whether a combination of different nutritional assessment methods would be useful for assessing prognosis in patients with acute decompensated heart failure (ADHF).This prospective study included 52 patients with ADHF (mean age, 71.1 ± 14.7 years; men 55.8%) who were admitted to our hospital between June 2012 and August 2013. On admission, nutritional status was evaluated according to levels of TTR and the MNA. Of 52 patients, 28 (53.8%) had TTR < 15 mg/dL, 39 (75.0%) had malnutrition or were at risk of malnutrition (MNA score ≤ 23.5), and 21 (40.4%) were categorized into group L (MNA score ≤ 23.5 and TTR < 15 mg/dL). Readmission due to worsening heart failure occurred in 12 patients (23.1%), and there were 4 (7.7%) allcause deaths. The 1-year event-free survival rates in group L and the remaining patients (group O) were 27.7% and 85.6%, respectively (P = 0.001). Using Cox multivariate analysis, group L also had a poorer prognosis (hazard ratio 4.35, 95% confidence interval 1.26-17.74, P = 0.020).MNA revealed that 75% of patients with ADHF had malnutrition or were at risk of malnutrition. The combination of low MNA and low TTR on admission can predict the prognosis of patients with ADHF. (Int Heart J 2015; 56: 226-233)

Nutrition‐related risk and severe hypoglycemia in older adult outpatients with and without diabetes

Kimura

Akazawa

2022

Clinical Case Reports