Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database

Abstract

BackgroundMalnutrition is associated with poor prognosis in patients with acute myocardial infarction (AMI). However, the prognostic impact of malnutrition in critical patients with AMI has not been well addressed.MethodsWe analyzed two critical AMI cohorts from Cardiorenal ImprovemeNt (CIN) in China and Medical Information Mark for Intensive Care-III (MIMIC-III) in the United States. The primary outcome was all-cause mortality. Cox proportional hazards models were constructed to examine the risk of malnutrition for mortality in critical patients with AMI.ResultsThere were 2,075 critical patients with AMI (mean age, 62.5 ± 12.3 years, 20.00% were female) from the CIN cohort and 887 critical patients with AMI (mean age, 70.1 ± 12.9 years, 37.43% were female) from MIMIC-III included in this study. Based on the Controlling Nutritional Status (CONUT) score, of the Chinese patients with AMI, the prevalence was 47.5, 28.3, and 3.5% for mild, moderate, and severe malnutrition, respectively. The percentage of mild, moderate, and severe malnutrition was 41.60, 30.55, and 7.32% in the MIMIC-III cohort, respectively. Controlling for confounders, worse nutritional state was significantly associated with increased risk for all-cause mortality [an adjusted hazard ratio for mild, moderate, and severe malnutrition, respectively, 1.10 (95% confidence interval (CI): 0.76–1.59), 1.49 (95% CI: 1.02–2.19), and 1.70 (95% CI: 1.00–2.88) in the CIN cohort and 1.41 (95% CI: 0.95–2.09), 1.97 (95% CI: 1.32–2.95), and 2.70 (95% CI: 1.67–4.37) in the MIMIC-III cohort].ConclusionMalnutrition was independently associated with an increased risk of all-cause mortality in critical patients with AMI after full adjustments. Further trials are needed to prospectively evaluate the efficacy of nutritional interventions in critical patients with AMI.

Establishment and evaluation of a nomogram for in-hospital new-onset atrial fibrillation after percutaneous coronary intervention for acute myocardial infarction

“…Nutritional status in these cases was further worsened due to disease progression or side effects of medications (23). Similarly, a study from the Chinese CIN and American MIMIC-III database reported that one-third of AMI patients were also at high risk of malnutrition (24). Studies have reported that malnutrition could advance the happening of NOAF in AMI patients (25,26).…”

The prognostic nutritional index predicts all-cause mortality in critically ill patients with acute myocardial infarction

“…Declining hemoglobin content, as a novel biomarker, can be regarded as an effective mortality predictor for patients with AMI, which provides a promising perspective to evaluate the prognosis of patients with AMI [ 24 ]. In addition, malnutrition is a common phenomenon in patients with AMI and is strongly associated with increased mortality and cardiovascular events [ 6 , 25 , 26 ]. What is more, it is known to us all that inflammatory response has been proven to play a significant role in the whole process of AMI [ 27 ].…”

Different antihypertensive and metabolic responses to rostafuroxin in undernourished and normonourished male rats: Outcomes on bodily Na+ handling

“…Undernutrition, especially chronic undernutrition, has been associated with renal and cardiovascular pathologies, including arterial hypertension (Eroğlu, 2019 ; Global Burden of Diseases, Injuries and Risk Factors Study/GBD, 2019 ; Lu et al, 2022 ). These studies have shown that unhealthy diets and poor nutrition are among the main risk and aggravating factors for these diseases worldwide.…”