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He F, Huang H, Xu W, Cui K, Ruan Y, Guo Y, Wang J, Bin J, Wang Y, Chen Y. Prognostic impact of malnutrition in patients with coronary artery disease: a systematic review and meta-analysis. Nutr Rev 2024; 82:1013-1027. [PMID: 37665731 DOI: 10.1093/nutrit/nuad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
CONTEXT Conflicting predictions of malnutrition for the long-term prognosis of coronary artery disease (CAD) exist. OBJECTIVE This study aimed to investigate the relationship between malnutrition and long-term prognosis of patients with CAD. DATA SOURCES Four databases were searched for articles from February 11, 1936, to September 10, 2022. DATA EXTRACTION Cohort studies adjusting for multiple cardiovascular risk factors with data on CAD and malnutrition were included. Malnutrition was measured and defined by different nutritional evaluation tools. The hazard ratios (HRs) and confidence intervals (CIs) for all-cause mortality and major adverse cardiovascular events (MACEs) were synthesized. Subgroup analyses were performed based on study design, assessment tools, ethnicity/race, follow-up, sample size, and types of CAD. Meta-regression was used to compare whether the effect sizes of the 2 subgroups were statistically significant. DATA ANALYSIS A total of 30 cohort studies were included, totaling 81 361 participants with CAD. Nutritional evaluation tools, including the Geriatric Nutritional Risk Index (GNRI), Controlling Nutritional Status (CONUT), Nutritional Risk Screening 2002, Mini-Nutritional Assessment, and Prognostic Nutritional Index, were used. Malnutrition increased all-cause mortality (HR = 1.72; 95% CI: 1.53, 1.93) and MACEs (HR = 1.47; 95% CI: 1.35, 1.60) in patients with CAD. Subgroup analysis revealed the results were consistent across study design, ethnicity/race, follow-up, sample size, and types of CAD. Subgroup analyses and meta-regression revealed that malnutrition was associated with a higher risk of all-cause mortality (HR = 2.26; 95% CI: 1.91, 2.68) and MACEs (HR = 2.28; 95% CI: 1.69, 3.08) in patients with stable CAD than those with other types of CAD. Meta-regression revealed that the GNRI (HR = 2.20; 95% CI: 1.65, 2.93) was more effective than CONUT (HR = 1.47; 95% CI: 1.21, 1.78) in predicting all-cause mortality. CONCLUSION Malnutrition independently increased all-cause mortality by 72% and MACEs by 47% in patients with CAD, especially with stable CAD. The GNRI is a more effective nutritional evaluation tool than CONUT in predicting all-cause mortality.
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Affiliation(s)
- Fengling He
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Haoxiang Huang
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Wenlong Xu
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Kai Cui
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Yifei Ruan
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Yuetong Guo
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Junfen Wang
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jianping Bin
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Yuegang Wang
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
| | - Yanmei Chen
- Department of Cardiology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation , Southern Medical University, Guangzhou, China
- Department of Cardiology, Ganzhou People's Hospital, Guangzhou, China
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An S, Li J, Jin H, Chai L, Song P, Chen L, Yang D. Predictive value of the controlling nutritional status (CONUT) score to assess long-term mortality (10 Years) in patients with hypertension. Nutr Metab Cardiovasc Dis 2024:S0939-4753(24)00241-2. [PMID: 39098376 DOI: 10.1016/j.numecd.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/29/2024] [Accepted: 06/18/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND AND AIMS Malnutrition is associated with poor outcomes in patients with chronic diseases. The aim of this study is to investigate the prevalence of malnutrition in patients with hypertension and relationship between malnutrition severity and long-term mortality in these patients. METHODS AND RESULTS The study included 11,278 patients with hypertension from the National Health and Nutrition Examination Survey database. The degree of malnutrition was assessed using the Controlled Nutritional Status score, with patients divided into normal, mild, and moderate-to-severe groups. After 10 years of follow-up, the results showed that patients who died had higher CONUT scores, poorer nutritional status, and lower albumin, total cholesterol, and lymphocytes than those who survived (P < 0.05). The Kaplan-Meier analysis revealed that patients with poor nutritional status had a significantly higher risk of all-cause death. In the Non-Lipid Lowering Drugs group, the CONUT score (hazard ratio (HR): 1.225; 95% confidence interval (CI): 1.162-1.292; P < 0.0001), as well as mild (HR: 1.532; 95% CI 1.340-1.751; P < 0.0001) and moderate-to-severe malnutrition (HR: 2.797; 95% CI: 1.441-5.428; P = 0.0024), were independent predictors of long-term mortality. The competing risk regression models showed that cardiovascular and cerebrovascular mortality increased with increasing CONUT scores. The results were robust in both subgroup and sensitivity analyses. CONCLUSIONS Malnutrition significantly impacts long-term mortality in hypertensive patients. The CONUT score may be a useful tool for assessing the nutritional status of patients with hypertension in the non-lipid-lowering population and for predicting their long-term mortality.
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Affiliation(s)
- Shuo An
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jie Li
- Department of Cardiology, Ruijin Hainan Hospital Shanghai Jiao Tong University School of Medicine (Hainan Boao Research Hospital), Qionghai, China
| | - Hui Jin
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Lu Chai
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Pengyu Song
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Liang Chen
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China.
| | - Donghui Yang
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, China.
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Tiryaki MM, Emren SV, Gursoy MO, Kiris T, Esin F, Esen S, Karaca M, Nazli C. The Relationship Between Controlling Nutritional Assessment Score and Mortality in Patients with Chronic Coronary Syndrome: A Retrospective Study from Türkiye. Niger J Clin Pract 2024; 27:612-619. [PMID: 38842711 DOI: 10.4103/njcp.njcp_769_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/12/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Controlling Nutritional Assessment (CONUT) score has been shown to have a higher predictive value compared to other nutritional scores in acute coronary syndrome. AIM To determine the relationship between CONUT score and long-term mortality in patients with chronic coronary syndrome (CCS). METHODS Between 2017 and 2020, 585 consecutive patients newly diagnosed and proven to have CCS by coronary angiography were included in the study. CONUT score and demographic and laboratory data of all patients were evaluated. The relationship between results and mortality was evaluated. RESULTS The mean age of the patients was 64 years and 75% were male. Mortality was observed in 56 (9.6%) patients after a median follow-up period of 3.5 years. The median CONUT score was significantly higher in patients with mortality (P < 0.001). In multivariate regression analysis, the CONUT score was associated with mortality (Hazard ratio (HR): 1.63 (95% confidence interval (CI): 1.34-1.98 P < 0.001)). The area under curve (AUC) for long-term mortality estimation for the CONUT score was 0.75 (95% CI 0.67-0.82 P < 0.001). When the CONUT score value was accepted as 0.5, the sensitivity was 78% and the specificity was 60. CONCLUSION CONUT score was found to be predictive of mortality in long-term follow-up of patients with CCS.
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Affiliation(s)
- M M Tiryaki
- Department of Cardiology, Bulanik State Hospital, Mus, Turkiye
| | - S V Emren
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - M O Gursoy
- Department of Cardiology, Bozyaka Training and Research Hospital, Izmir, Turkiye
| | - T Kiris
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - F Esin
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - S Esen
- Department of Cardiology, Tunceli State Hospital, Tunceli, Turkiye
| | - M Karaca
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - C Nazli
- Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
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Jalali A, Hassanzadeh A, Najafi MS, Nayebirad S, Dashtkoohi M, Karimi Z, Shafiee A. Predictors of major adverse cardiac and cerebrovascular events after percutaneous coronary intervention in older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:337. [PMID: 38609875 PMCID: PMC11015672 DOI: 10.1186/s12877-024-04896-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
AIM We systematically reviewed and meta-analyzed the predictors of major adverse cardiac and cerebrovascular events (MACE/MACCE) in older adults who underwent PCI. METHODS Three databases, PubMed, Embase, and Scopus, were searched for observational studies considering the out-of-hospital MACE/MACCE in adults ≥ 60 years old with coronary artery disease (acute or chronic) who underwent PCI. Studies were eligible if they had determined at least two statistically significant predictors of MACE/MACCE by multivariable analysis. We used the QUIPS tool to evaluate the risk of bias in the studies. Random-effects meta-analysis was utilized to pool the hazard ratios (HRs) of the most reported predictors. RESULTS A total of 34 studies were included in the review. Older age (HR = 1.04, 95% Confidence Interval (CI): 1.03-1.06, P-value < 0.001), diabetes (HR = 1.36, 95% CI: 1.22-1.53, P < 0.001), history of myocardial infarction (MI) (HR = 1.88, 95% CI: 1.37-2.57, P < 0.001), ST-elevation MI (STEMI) at presentation (HR = 1.72, 95% CI: 1.37-2.18, P < 0.001), reduced left ventricular ejection fraction (LVEF) (HR = 2.01, 95% CI: 1.52-2.65, P < 0.001), successful PCI (HR = 0.35, 95% CI: 0.27-0.47, P < 0.001), eGFR (HR = 0.99, 95% CI: 0.97-1.00; P-value = 0.04) and left main coronary artery (LMCA) disease (HR = 2.07, 95% CI: 1.52-2.84, P < 0.001) were identified as predictors of MACE. CONCLUSION We identified older age, diabetes, history of MI, STEMI presentation, lower LVEF, and LMCA disease increased the risk of MACE/MACCE after PCI in older adults. Meanwhile, higher eGFR and successful PCI predicted lower adverse events risk. Future studies should focus on a more robust methodology and a precise definition of MACE. REGISTRATION PROSPERO (CRD42023480332).
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Affiliation(s)
- Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411713138, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hassanzadeh
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadeq Najafi
- Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Nayebirad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411713138, Tehran, Iran
| | - Mohadese Dashtkoohi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411713138, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411713138, Tehran, Iran.
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Li M, Cai J, Jiang K, Li Y, Li S, Wang Q, Liu H, Qu X, Kong C, Shi K. Prognostic nutritional index during hospitalization correlates with adverse outcomes in elderly patients with acute myocardial infarction: a single-center retrospective cohort study. Aging Clin Exp Res 2024; 36:56. [PMID: 38441718 PMCID: PMC10914925 DOI: 10.1007/s40520-024-02702-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/11/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND AND AIMS Acute myocardial infarction (AMI) is one of the most prevalent illnesses endangering the elderly's health. The predictive nutritional index (PNI) has been shown in several studies to be a good predictor of nutritional prognosis. In this study, we explored the correlation between PNI during hospitalization and the outcome of elderly AMI patients. METHODS Elderly AMI patients in the Cardiac Intensive Care Unit of Huadong Hospital from September 2017 to April 2020 were recruited for analysis. The clinical and laboratory examination data of subjects were retrieved. All enrolled patients were monitored following discharge. The primary clinical endpoints encompass major adverse cardiovascular events (MACEs) and Composite endpoint (MACEs and all-cause mortality). Survival analyses were conducted via the Kaplan-Meier and the log-rank analyses, and the Cox, proportional hazards model, was employed for hazard rate (HR) calculation. RESULTS 307 subjects were recruited for analysis. The optimal PNI threshold is 40.923. Based on the Kaplan-Meier analysis, the elevated PNI group experienced better prognosis (P < 0.001). Cox analysis demonstrated that the PNI group was a stand-alone predictor for elderly AMI patient prognosis (HR = 1.674, 95% CI 1.076-2.604, P = 0.022). Subgroup analysis showed that the HR of the PNI group was the highest in the ST-segment elevation myocardial infarction (STEMI) subgroup (HR = 3.345, 95% CI 1.889-5.923, P = 0.05), but no discernible difference was observed in the non-ST-segment elevation myocardial infarction (NSTEMI) subgroup. CONCLUSION Based on our analyses, the PNI during hospitalization can accurately predict the prognosis of elderly STEMI patients but not that of elderly NSTEMI patients.
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Affiliation(s)
- Mingxuan Li
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- Department of Cardiology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jiasheng Cai
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Kewei Jiang
- Department of Respiratory Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yanglei Li
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Siqi Li
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Qingyue Wang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Haibo Liu
- Department of Cardiology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
| | - Chengqi Kong
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
| | - Kailei Shi
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
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Lai ARX, Warrier M, Ng EZX, Lin C, Chin YH, Kong G, Anand VV, Lee ECZ, Lai H, Ng HW, Goh RSJ, Chong B, Muthiah MD, Khoo CM, Wang JW, Tse G, Loh PH, Mehta A, Brown A, Dimitriadis GK, Chan MY, Chew NW. Cardiovascular Outcomes in Acute Coronary Syndrome and Malnutrition: A Meta-Analysis of Nutritional Assessment Tools. JACC. ADVANCES 2023; 2:100635. [PMID: 38938362 PMCID: PMC11198676 DOI: 10.1016/j.jacadv.2023.100635] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/24/2023] [Accepted: 08/10/2023] [Indexed: 06/29/2024]
Abstract
Background There is emerging evidence that malnutrition is associated with poor prognosis among patients with acute coronary syndrome (ACS). Objectives This study seeks to elucidate the prognostic impact of malnutrition in patients with ACS and provide a quantitative review of most commonly used nutritional assessment tools. Methods Medline and Embase were searched for studies reporting outcomes in patients with malnutrition and ACS. Nutritional screening tools of interest included the Prognostic Nutrition Index, Geriatric Nutritional Risk Index, and Controlling Nutritional Status. A comparative meta-analysis was used to estimate the risk of all-cause mortality and cardiovascular events based on the presence of malnutrition and stratified according to ACS type, ACS intervention, ethnicity, and income. Results Thirty studies comprising 37,303 patients with ACS were included, of whom 33.5% had malnutrition. In the population with malnutrition, the pooled mortality rate was 20.59% (95% CI: 14.95%-27.67%). Malnutrition was significantly associated with all-cause mortality risk after adjusting for confounders including age and left ventricular ejection fraction (adjusted HR: 2.66, 95% CI: 1.78-3.96, P = 0.004). There was excess mortality in the group with malnutrition regardless of ACS type (P = 0.132), ethnicity (P = 0.245), and income status (P = 0.058). Subgroup analysis demonstrated no statistically significant difference in mortality risk between individuals with and without malnutrition (P = 0.499) when using Controlling Nutritional Status (OR: 7.80, 95% CI: 2.17-28.07, P = 0.011), Geriatric Nutritional Risk Index (OR: 4.30, 95% CI: 2.78-6.66, P < 0.001), and Prognostic Nutrition Index (OR: 4.67, 95% CI: 2.38-9.17, P = 0.023). Conclusions Malnutrition was significantly associated with all-cause mortality risk following ACS, regardless of ACS type, ethnicity, and income status, underscoring the importance of screening and interventional strategies for patients with malnutrition.
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Affiliation(s)
- Angeline RX. Lai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Manish Warrier
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ethel ZX. Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chaoxing Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Vickram V. Anand
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ethan CZ. Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Haoxing Lai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hung Wei Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rachel SJ. Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Bryan Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark D. Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Chin Meng Khoo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Endocrinology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Jiong-Wei Wang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Surgery, Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore
- Nanomedicine Translational Research Program, Centre for NanoMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gary Tse
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Poay Huan Loh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Anurag Mehta
- Division of Cardiology, Department of Internal Medicine, VCU Health Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Adrian Brown
- UCL Centre for Obesity Research, University College London, London, Greater London, United Kingdom
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, Greater London, United Kingdom
- National Institute of Health Research, UCLH Biomedical Research Centre, London, Greater London, United Kingdom
| | - Georgios K. Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, London, United Kingdom
- Faculty of Cardiovascular Medicine & Sciences, Department of Diabetes, Obesity, Type 2 Diabetes and Immunometabolism Research Group, School of Life Course Sciences, King’s College London, London, United Kingdom
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Nicholas W.S. Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
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Yan H, Yao W, Yang Q, Li C, Wang Z, Li T, Li Y, Song K, Zhang F, Dang Y. Association between Malnutrition and Coronary Plaque Characteristics in Patients with Acute Coronary Syndrome: An Optical Coherence Tomography Study. Rev Cardiovasc Med 2023; 24:303. [PMID: 39077570 PMCID: PMC11273137 DOI: 10.31083/j.rcm2410303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/31/2024] Open
Abstract
Background Malnutrition has a negative impact on patients with arteriosclerotic cardiovascular disease (ASCVD); however, only a few studies have confirmed the effect of malnutrition on atherosclerosis. We aimed to investigate the association between malnutrition and vulnerable plaques via optical coherence tomography (OCT). Methods Overall, 142 acute coronary syndrome (ACS) patients were included in this study. Malnutrition was assessed using the Controlled Nutritional Status Score (CONUT), and plaque vulnerability was measured using OCT. Finally, patients were divided into four groups according to their CONUT scores and body mass index (BMI) ≥ 25.0 or not, to further compare the effects of both factors on plaque characteristics in patients. Results OCT results showed that there were significant differences in plaque rupture, thin cap fibroatheroma (TCFA), minimal fiber cap thickness (FCT), thrombus, and macrophage infiltration between different nutritional states [Absent (0-1) vs Mild (2-4) vs Moderate (5-8), plaque rupture: 34.8% vs 52.5% vs 66.7%, p = 0.038; TCFA: 10.1% vs 24.6% vs 33.3%, p = 0.039; minimal FCT: 125.0 vs 110.4 vs 96.9, p = 0.022; thrombus: 50.7% vs 70.5% vs 83.3%, p = 0.019]. Multivariate logistic regression showed that malnutrition was a significant predictor of plaque vulnerability. Plaque rupture: CONUT score (odds ratio [OR]: 1.448, 95% confidence interval [CI]: 1.136-1.845, p = 0.003), Mild (OR: 1.981, 95% CI: 0.932-4.210, p = 0.075), and Moderate (OR: 4.375, 95% CI: 1.048-18.255, p = 0.043); TCFA: CONUT score (OR: 1.334, 95% CI: 1.029-1.730, p = 0.030), Mild (OR: 3.518, 95% CI: 1.251-9.897, p = 0.017), and Moderate (OR: 4.863, 95% CI: 1.019-23.208, p = 0.047); and macrophage: CONUT score (OR: 1.343, 95% CI: 1.060-1.700, p = 0.015), Mild (OR: 3.016, 95% CI: 1.305-6.974, p = 0.010), and Moderate (OR: 4.637, 95% CI: 1.159-18.552, p = 0.030). Combined CONUT score and BMI showed an independent association with macrophages in the malnourished and overweight group (OR: 4.010, 95% CI: 1.188-13.537, p = 0.025). Conclusions Malnutrition is a predictor of vulnerable plaques and is associated with inflammatory progression.
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Affiliation(s)
- Haihao Yan
- Department of Internal Medicine, Graduate School of Hebei Medical University, 050017 Shijiazhuang, Hebei, China
| | - Wenjing Yao
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Qian Yang
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Congcong Li
- Department of Internal Medicine, Graduate School of Hebei Medical University, 050017 Shijiazhuang, Hebei, China
| | - Zhenyu Wang
- Department of Internal Medicine, Graduate School of Hebei Medical University, 050017 Shijiazhuang, Hebei, China
| | - Tianxing Li
- Department of Graduate School of Hebei North University, 075000 Zhangjiakou, Hebei, China
| | - Yanhong Li
- Department of Internal Medicine, Graduate School of Hebei Medical University, 050017 Shijiazhuang, Hebei, China
| | - Kexin Song
- Department of Internal Medicine, Graduate School of Hebei Medical University, 050017 Shijiazhuang, Hebei, China
| | - Feifei Zhang
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
| | - Yi Dang
- Department of Cardiology Center, Hebei General Hospital, 050051 Shijiazhuang, Hebei, China
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Chang WT, Sun CK, Wu JY, Yu CH, Chang YJ, Lin MC, Lan KM, Chen IW, Hung KC. Association of prognostic nutritional index with long-term mortality in patients receiving percutaneous coronary intervention for acute coronary syndrome: a meta-analysis. Sci Rep 2023; 13:13102. [PMID: 37567925 PMCID: PMC10421894 DOI: 10.1038/s41598-023-40312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023] Open
Abstract
The predictive value of the prognostic nutritional index (PNI) for the long-term prognosis of patients with acute coronary syndrome (ACS) remains uncertain. Medline, Embase, Cochrane Library, and Google Scholar were searched from inception until January 2023 to study the relationship between all-cause mortality risk and PNI in patients receiving percutaneous coronary intervention for ACS (i.e., primary outcome). Thirteen observational studies were included in this meta-analysis. Analysis of seven studies using PNI as a categorical variable showed a pooled hazard ratio (HR) of all-cause mortality of 2.97 (95% CI 1.65 to 5.34, p = 0.0003, I2 = 89%, n = 11,245) for patients with a low PNI. The meta-analysis also showed a higher risk of major adverse cardiovascular events (MACEs) in patients with a low PNI (HR 2.04; 95% CI 1.59 to 2.61; p < 0.00001; I2 = 21%; n = 8534). Moreover, advanced age, diabetes mellitus, and high Global Registry of Acute Coronary Events risk scores were associated with a high risk of all-cause mortality, whereas a high body mass index was associated with a low risk of all-cause mortality. The results showed an association between a low PNI and an increased risk of long-term mortality in patients undergoing coronary interventions for ACS. Further randomized controlled trials are necessary to confirm these findings.
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Affiliation(s)
- Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan City, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan City, Taiwan
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chia-Hung Yu
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Ming-Chung Lin
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Kuo-Mao Lan
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung City, Taiwan.
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9
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Moltó-Balado P, Reverté-Villarroya S, Monclús-Arasa C, Balado-Albiol MT, Baset-Martínez S, Carot-Domenech J, Clua-Espuny JL. Heart Failure and Major Adverse Cardiovascular Events in Atrial Fibrillation Patients: A Retrospective Primary Care Cohort Study. Biomedicines 2023; 11:1825. [PMID: 37509465 PMCID: PMC10376826 DOI: 10.3390/biomedicines11071825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with an increased risk of major adverse cardiovascular events (MACE). The main goal was to analyze the links and associations between AF and MACE. METHODS A multicenter, observational, retrospective, community-based study of a cohort (n = 40,297) of the general population aged 65-95 years between 1 January 2015 and 31 December 2021 without a previous diagnosis of AF or MACE in the Primary Care setting. RESULTS 2574 people (6.39%) developed a first AF event, resulting in an overall incidence of 8.9/1000 people-years [CI95% 8.6-9.2]. The incidence of MACE among those with AF was 75.1/1000 people-years [CI95% 70.8-79.5], whereas among those without AF, it was 20.6/1000 people-years [CI 95% 20.2-21.1], resulting in a rate ratio of 3.65 [CI 95% 3.43-3.88, p < 0.001]. Besides, the incidence of HF with AF was 40.1 people-years [CI 95% 37.1-43.2], while in the group without AF, it was 8.3 people-years [CI 95% 7.9-8.6, p < 0.001], with a rate ratio of 4.85 [CI 95% 4.45-55.3, p < 0.001]. Before an AF diagnosis, there is already a higher risk of chronic kidney disease, ischemic cardiopathy, and peripheral artery disease. A higher risk of poor nutritional status was detected among those with MACE (49.7% vs. 26.6%, p < 0.001). CONCLUSIONS AF diagnosis increases the incidence of heart failure fourfold. Additional information is required to establish the connection between AF, major adverse cardiovascular events, and nutritional status.
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Affiliation(s)
- P Moltó-Balado
- Primary Health-Care Centre Tortosa Oest, Institute Català de la Salut, Primary Care Service (SAP) Terres de l'Ebre, 43500 Tortosa, Spain
- Biomedicine Doctoral Programme, Universitat Rovira I Virgili, 43500 Tortosa, Spain
| | - S Reverté-Villarroya
- Biomedicine Doctoral Programme, Advanced Nursing Research Group, Nursing Department, Campus Terres de l'Ebre, Universitat Rovira I Virgili, 43500 Tortosa, Spain
| | - C Monclús-Arasa
- Primary Health-Care Centre Tortosa Oest, Institute Català de la Salut, Primary Care Service (SAP) Terres de l'Ebre, 43500 Tortosa, Spain
| | - M T Balado-Albiol
- Conselleria de Sanitat, Departament de Salut de La Plana, Primary Health-Care Centre CS Burriana I, 12540 Burriana, Spain
| | - S Baset-Martínez
- Nusing Management Primary Health-Care Center Tortosa Est, Institut Català de la Salut, Primary Care Service (SAP) Terres de l'Ebre, 43500 Tortosa, Spain
| | - J Carot-Domenech
- Direction of Information and Communication Systems, Territorial Management of Terres de l'Ebre, Institut Català de la Salut, 43500 Tortosa, Spain
| | - J L Clua-Espuny
- Ebrictus Research Group, Research Support Unit Terres de l'Ebre, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 43500 Tortosa, Spain
- Primary Health-Care Center Tortosa Est, Institut Català de la Salut, Primary Care Service (SAP) Terres de l'Ebre, 43500 Toosa, Spain
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10
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Zhang S, Wang H, Chen S, Cai S, Zhou S, Wang C, Ni X. Prognostic nutritional index and prognosis of patients with coronary artery disease: A systematic review and meta-analysis. Front Nutr 2023; 10:1114053. [PMID: 37006923 PMCID: PMC10061069 DOI: 10.3389/fnut.2023.1114053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundThis review assessed if prognostic nutritional index (PNI) can predict mortality and major adverse cardiac events (MACE) in coronary artery disease (CAD) patients.MethodsPubMed, Web of Science, Scopus, and Embase were searched up to 1st November 2022 for all types of studies reporting adjusted associations between PNI and mortality or MACE in CAD patients. A random-effect meta-analysis was conducted for PNI as categorical or continuous variable. Subgroup analysis were conducted for multiple confounders.ResultsFifteen studies with 22,521 patients were included. Meta-analysis found that low PNI was a significant predictor of mortality in CAD patients as compared to those with high PNI (HR: 1.67 95% CI: 1.39, 2.00 I2 = 95% p < 0.00001). Increasing PNI scores were also associated with lower mortality (HR: 0.94 95% CI: 0.91, 0.97 I2 = 89% p = 0.0003). Meta-analysis demonstrated that patients with low PNI had significantly higher incidence of MACE (HR: 1.57 95% CI: 1.08, 2.28 I2 = 94% p = 0.02) and increasing PNI was associated with lower incidence of MACE (HR: 0.84 95% CI: 0.72, 0.92 I2 = 97% p = 0.0007). Subgroup analyses showed mixed results.ConclusionMalnutrition assessed by PNI can independently predict mortality and MACE in CAD patients. Variable PNI cut-offs and high inter-study heterogeneity are major limitations while interpreting the results. Further research focusing on specific groups of CAD and taking into account different cut-offs of PNI are needed to provide better evidence.Systematic Review RegistrationNo CRD42022365913 https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Shengjing Zhang
- Department of Geriatrics, Affiliated Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Wenzhou, China
| | - Huanfen Wang
- Department of Geriatrics, Affiliated Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Wenzhou, China
| | - Saiya Chen
- Department of Geriatrics, Affiliated Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Wenzhou, China
| | - Shengsheng Cai
- Department of Geriatrics, Affiliated Wenzhou Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Wenzhou, China
| | - Shigeng Zhou
- Department of Geriatrics, Wenzhou Geriatric Hospital, Wenzhou, China
| | - Congling Wang
- Department of Geriatrics, Wenzhou Geriatric Hospital, Wenzhou, China
| | - Xiuyuan Ni
- Department of Geriatrics, Wenzhou Geriatric Hospital, Wenzhou, China
- *Correspondence: Xiuyuan Ni,
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11
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Huang L, He R, Sun X, Lv J, Chen S. Association of Controlling Nutritional Status Score With Adverse Outcomes in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Angiology 2023; 74:149-158. [PMID: 35491724 DOI: 10.1177/00033197221094409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This systematic review and meta-analysis sought to examine the association between the controlling nutritional status (CONUT) score and adverse outcomes in patients with coronary artery disease (CAD). PubMed and Embase databases were searched for eligible studies from their inceptions to December 12, 2021 to identify studies investigating the association of the CONUT score with major adverse cardiovascular events (MACEs) and all-cause mortality in CAD patients. Twelve studies (36,198 CAD) patients satisfied the criteria. Comparison of the high with low CONUT score, the pooled multivariate adjusted risk ratios (RR) was 1.78 (95% confidence intervals [CI] 1.36-2.32) for MACEs and 1.45 (95% CI 1.27-1.66) for all-cause mortality, respectively. When compared with patients with normal nutrition, malnourished (defined by the CONUT score ≥2) patients conferred a 52% increased risk of MACEs. Additionally, per point CONUT score increment was associated with 15% and 11% higher risk of MACEs and all-cause mortality, respectively. Higher CONUT score independently predicts the MACEs all-cause mortality in CAD patients. Estimation of nutritional status using the CONUT score could be helpful for improving risk classification of CAD.
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Affiliation(s)
- Lijun Huang
- Department of Cardiac and Vascular Surgery, 584020Zhejiang Hospital, Hangzhou, China
| | - Renliang He
- Department of Cardiac and Vascular Surgery, 584020Zhejiang Hospital, Hangzhou, China
| | - Xiajun Sun
- Department of Gastroenterology, 584020Zhejiang Hospital, Hangzhou, China
| | - Jing Lv
- Department of General Practice, 584020Zhejiang Hospital, Hangzhou, China
| | - Shaoxi Chen
- Department of Cardiac and Vascular Surgery, 584020Zhejiang Hospital, Hangzhou, China
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12
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Prognostic Nutritional Index and Major Cardiovascular Events in Patients Undergoing Invasive Coronary Angiography: A Clinical Retrospective Study. J Pers Med 2022; 12:jpm12101679. [PMID: 36294818 PMCID: PMC9604840 DOI: 10.3390/jpm12101679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
We aimed to examine whether prognostic nutritional index (PNI) could serve as an auxiliary predictor for major cardiovascular events (MCEs) in patients undergoing invasive coronary angiography (ICA). A total of 485 participants were enrolled, divided into low-PNI (≥47.40) and high-PNI (<47.40) groups. ICA determined the stenotic vessels of coronary artery disease. The primary outcome was incidental MCEs, a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or rehospitalization of in-stent restenosis. There were 47 (9.69%) MCEs during the 3.78-years follow-up. The cumulative incidence of MCEs was significantly higher in the low-PNI patients compared with the high-PNI patients (17.07% vs. 7.18%, p = 0.001). Malnutrition risk (low PNI) was significantly and independently associated with a higher risk of MCEs (hazard ratios: 2.593, 95% confidence intervals [CI]: 1.418−4.742). Combined use of the number of stenotic vessels with malnutrition risk showed a higher capacity to predict the MCEs than the presence of stenotic vessels alone (areas under the receiver operator characteristic curve: 0.696 [95% CI, 0.618−0.775] vs. 0.550 [95% CI, 0.466−0.633], p = 0.013). In conclusion, lower PNI levels may predict a higher risk of cardiovascular events in patients undergoing ICA, which supports the necessity of the risk assessment of nutrition status and guide the clinical treatment on strengthening nutritional support before ICA is performed, as well as nutritional intervention after ICA.
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Arero G, Arero AG, Mohammed SH, Vasheghani-Farahani A. Prognostic Potential of the Controlling Nutritional Status (CONUT) Score in Predicting All-Cause Mortality and Major Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Meta-Analysis. Front Nutr 2022; 9:850641. [PMID: 35614981 PMCID: PMC9125241 DOI: 10.3389/fnut.2022.850641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/30/2022] [Indexed: 01/01/2023] Open
Abstract
Background As defined by the Controlling Nutrition Status (CONUT) score, the prognostic significance of nutritional status has attracted attention in patients with cardiovascular disease. This meta-analysis aimed to determine the importance of CONUT score for prediction of all-cause mortality and major adverse cardiovascular events (MACE) in adult patients with coronary artery disease (CAD). Methods Observational studies conducted to evaluate the association of CONUT score with adverse clinical outcomes in patients with CAD were included. We searched MEDLINE, Embase, Scopus, Cochrane library, Google scholar, medRxiv pre-print as well as Science Direct search engine for studies published from the inception of each database until March 21, 2022. Studies reporting the utility of CONUT score in prediction of all-cause mortality and MACE among patients with CAD were eligible. Predictive potential of the CONUT score were summarized by pooling the multivariable adjusted hazard ratio (aHR) with 95% CI for the malnourished vs. normal nutritional status or per point CONUT score increase. Results Of 2,547 screened citation, nine observational studies involving 81,257 patients with CAD were analyzed. Malnutrition defined by the CONUT score was associated with significantly increased risk of all-cause mortality when compared with the normal nutritional state (aHR for mild, moderate, and severe malnutrition, respectively: (1.21 [95% CI: 1.15–1.27], I2 = 0%), (1.53 [95% CI: 1.26–1.84], I2 = 84%), and (2.24 [95% CI: 1.57–3.19], I2 = 77%). Similarly, moderate (aHR 1.71 [95% CI: 1.44–2.03], I2 = 0%) and severe (aHR 2.66 [95% CI: 1.82–3.89], I2 = 0%) malnutrition was associated with a significantly higher risk of MACE compared with the normal nutritional state. Additionally, per point increase in the CONUT score was correlated with 20 and 23% additional risk of all-cause mortality and MACE, respectively. Conclusion As defined by the CONUT score, malnutrition is an independent predictor of all-cause mortality and MACE in CAD patients. Nutritional assessment with CONUT score could allow clinicians to identify patients with CAD at high risk for adverse clinical outcomes.
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Affiliation(s)
- Godana Arero
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
- *Correspondence: Godana Arero,
| | - Amanuel Godana Arero
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Addis Ababa, Ethiopia
| | | | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Fan Y, He L, Zhou Y, Man C. Predictive Value of Geriatric Nutritional Risk Index in Patients With Coronary Artery Disease: A Meta-Analysis. Front Nutr 2021; 8:736884. [PMID: 34660665 PMCID: PMC8511313 DOI: 10.3389/fnut.2021.736884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Low Geriatric Nutritional Risk Index has been identified as an index of impaired nutritional state. The objective of the meta-analysis was to assess the association of the Geriatric Nutritional Risk Index (GNRI) with adverse outcomes in patients with coronary artery disease (CAD). Methods: Relevant studies were identified by comprehensively searching PubMed and Embase databases in May 2021. Studies assessing the association of GNRI with all-cause mortality or major adverse cardiovascular events (MACEs) in patients with CAD were included. The predictive value of GNRI was summarized by pooling multivariable adjusted risk ratios (RR) with 95% confidence intervals (CI) per GNRI point decrease or the lowest vs. the highest GNRI group. Results: A total of eight studies involving 9277 patients with CAD were analyzed. Meta-analysis showed that the lowest GNRI was associated with a higher risk of all-cause mortality (RR 2.10; 95% CI 1.68–2.63) and MACEs (RR 2.84; 95% CI 1.56–5.16), respectively. Furthermore, per point decrease in GNRI was associated with 8 and 10% additional risk of all-cause mortality and MACEs. Subgroup analysis indicated that the value of low GNRI in predicting all-cause mortality was not affected by subtype of patients or follow-up duration. Conclusion: Low GNRI score at baseline was associated with a higher risk of all-cause mortality and cardiovascular events in patients with CAD. The nutritional state estimated by the GNRI score could provide important predictive information in patients with CAD.
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Affiliation(s)
- Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
| | - Lian He
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
| | - Yongjing Zhou
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
| | - Changfeng Man
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China
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