Prognostic performance of Controlling Nutritional Status score in patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention

Abstract

Objective: The effect of malnutrition in patients with ST segment elevation myocardial infarction (STEMI) is not fully understood. In this study, we tried to investigate the prognostic consequence of the Controlling Nutritional Status (CONUT) score in patients with STEMI. Methods: In this study, we evaluated the CONUT scores of 1,028 patients with STEMI and examined its relationship with major adverse cardiovascular events (MACE) (all-cause mortality, myocardial reinfarction, and vessel revascularization) during a period of 19.9±10.3 months. Patients with CONUT score ≥5 were defined as severely malnourished. Predictors of MACE were assessed by Cox regression analysis, and p<0.05 was considered to indicate statistical significance. Results: MACE was observed in a total of 147 (14.3%) patients. MACE was more frequent in the group with a higher CONUT score (33.3% vs. 10.9%, p<0.001). CONUT score ≥5 was an independent predictor of MACE in the Cox regression analysis (hazard ratio=2.50, 95% confidence interval: 1.61-3.90, p<0.001). Low ejection fraction, Killip class ≥3 at presentation, thrombolysis in myocardial infarction flow grade <3 after intervention, left main artery involvement, and low hemoglobin levels were other independent predictors of MACE in the long-term follow-up. Kaplan-Meier curves showed decreased MACE free survival rates in the high CONUT score group at a mean 19.9±10.3 months' follow-up duration (log-rank p<0.01). Conclusion: Malnutrition was strongly associated with poor outcomes in patients with STEMI treated using primary percutaneous coronary intervention.

Association of Malnutrition and High Bleeding Risk with Long-Term Prognosis in Patients with Acute Coronary Syndrome following Percutaneous Coronary Intervention

“…In this study, patients with moderate and severe malnutrition had more CKD than those with normal or mild malnutrition (Table S1), consistent with the findings of a previous study [12]. However, previous studies on the association between malnutrition and ACS prognosis included relatively young patients in their late 50 s and 60 s [13,14]. Meanwhile, the average age of the patients in this study was approximately 70 years, which reflects the age of many Japanese patients undergoing PCI [15,16].…”

Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction

“…This difference may partially be due to reduced mortality factors in similar studies, such as Killip classification, DM, and HT. 11,27 Likewise, we found that age, Killip class, hemoglobin, creatinine, LMCA stenosis, LVEF, and NPS were independent determinants of mortality among STEMI patients who underwent primary PCI. Besides, previous studies have shown that high CRP levels are associated with an increased incidence of in-hospital and long-term adverse outcomes in AMI patients.…”

“…8,9 Current studies have reported that a variety of inflammation-or nutrition-related indicators, such as the prognostic nutritional index (PNI), controlling nutritional status (CONUT), C-reactive protein (CRP)/albumin ratio, systemic inflammation score (SII), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), Glasgow prognostic score (GPS) and lymphocyte to monocyte ratio (LMR), might be related to outcomes in STEMI patients. [10][11][12][13][14][15] Nevertheless, these markers are still insufficient, and the results are controversial. Thus, more consistent, comprehensive, and effective risk assessment algorithms for STEMI patients are still required.…”

Association with controlling nutritional status score and disease activity of ulcerative colitis

“…A previous study demonstrated that 20% of overweight or obese patients with ST-segment elevation myocardial infarction had malnutrition. 20 This shows that malnutrition does not only occur in patients with a low BMI. Previous research has held the viewpoint that the severity of malnutrition in IBD patients is related to disease extent.…”