The Impact of Nutritional Status on the Outcome of Transcatheter Aortic Valve Implantation

Abstract

Background: The present study aims to evaluate how nutritional status may affect transcatheter aortic valve implantation (TAVI) outcomes. Materials and Methods: This is a retrospective study of 383 TAVI patients. In-hospital, 1-month, and 12-month survival was evaluated. Since most patients undergoing TAVI are over 75 years old, the NRI definition for a geriatric population (GNRI) was used. Preoperative baseline clinical and laboratory data were collected and then the corresponding nutritional status was calculated, including Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNRI), and Controlling Nutritional Status Score (CONUT). Survival analysis and receiver operating characteristic curve (ROC) analysis were used to evaluate the correlation between these parameters and TAVI outcome. Results: By CONUT and GNRI scores, 168 (58.9%) and 40 (14.0%) patients were considered to have mild malnutrition, respectively. By using PNI, CONUT, and GNRI scores, 16 (5.7%), 29 (10.3%), and 39 (13.7%) patients were moderately or severely malnourished. Survival analysis showed that patients with worse nutritional status had a worse prognosis regardless of the nutritional score used. Subgroup analysis showed that these differences remained significant in subgroups of patients over age 75. COX multivariate analysis showed that GNRI, PNI, and CONUT were independently associated with all-cause mortality during the follow-up. Conclusion: Patients with worse nutritional status had a worse prognosis regardless of the nutritional score used. Subgroup analysis showed that these differences remained significant in subgroups of patients over age 75. GNRI, PNI, and CONUT were independent predictors of all-cause mortality after TAVI.

Transcatheter Aortic Valve Implantation in Elderly Patients With Aortic Valve Stenosis: The Role of Frailty, Malnutrition, and Sarcopenia

“…As for other Asian populations, Lee et al 4 studied in South Korea the clinical usefulness of nutritional assessment tools for predicting the risk of mortality following TAVI and found that low GNRI was independently associated with a higher risk of 1‐year mortality. Furthermore, Sihag et al 5 demonstrated that patients with worse nutritional status in China had a worse prognosis regardless of the nutritional score used (GNRI, Prognostic Nutritional Index, or CONUT). Both studies 4 , 5 showed that the nutritional aspect seems to be a problem not only in Japan but also in other Asian populations as well.…”

“…Furthermore, Sihag et al 5 demonstrated that patients with worse nutritional status in China had a worse prognosis regardless of the nutritional score used (GNRI, Prognostic Nutritional Index, or CONUT). Both studies 4 , 5 showed that the nutritional aspect seems to be a problem not only in Japan but also in other Asian populations as well.…”