PMID- 36710105
OWN - NLM
STAT- MEDLINE
DCOM- 20230524
LR  - 20230524
IS  - 1590-3729 (Electronic)
IS  - 0939-4753 (Linking)
VI  - 33
IP  - 5
DP  - 2023 May
TI  - Prevalence and prognostic importance of malnutrition, as assessed by four 
      different scoring systems, in elder patients with heart failure.
PG  - 978-986
LID - S0939-4753(23)00009-1 [pii]
LID - 10.1016/j.numecd.2023.01.004 [doi]
AB  - BACKGROUND AND AIMS: The lack of standard diagnostic criteria in elder patients 
      with heart failure (HF) makes it challenging to diagnose and manage malnutrition. 
      We aimed to explore the prevalence of malnutrition, its associations and 
      prognostic significance among elder patients with HF using four different 
      nutritional scoring systems. METHODS AND RESULTS: Consecutively presenting 
      patients aged ⩾65 years, diagnosed with HF, and admitted to HF care unit of Fuwai 
      Hospital CAMS&PUMC (Beijing, China) were assessed for nutritional indices. In 
      total, 1371 patients were enrolled (59.4% men; mean age 72 years; median 
      NT-proBNP 2343 ng/L). Using scores for the prognostic nutritional index (PNI) 
      </=38, controlling nutritional status (CONUT) score >4, geriatric nutritional risk 
      index (GNRI) </=91, and triglycerides, total cholesterol, and body weight index 
      (TCBI) </=1109, 10.4%, 18.3%, 9.2%, and 50.0% of patients had moderate or severe 
      malnutrition, respectively. There was a strong association between worse scores 
      and lower body mass index, more severe symptoms, atrial fibrillation, and anemia. 
      The mortality over a median follow-up of 962 days (interquartile range (IQR): 
      903-1029 days) was 28.3% (n = 388). For those with moderate or severe condition, 
      1-year mortality was 35.2% for PNI, 28.3% for CONUT, 28.0% for GNRI, and 19.1% 
      for TCBI. Malnutrition, defined by any of the included indices, showed added 
      prognostic value when incorporated into a model and included preexisting 
      prognostic factors (C-statistic: 0.711). However, defining malnutrition by the 
      CONUT score yielded the most significant improvement in the prognostic predictive 
      value (C-statistic: 0.721; p < 0.001). CONCLUSION: Malnutrition is prevalent 
      among elder patients with HF and confers increased mortality risk. Among the 
      nutritional scores studied, the CONUT score was most effective in predicting the 
      mortality risk. CLINICAL TRIAL REGISTRATION: URL: ClinicalTrials.gov; Unique 
      Identifier: NCT02664818.
CI  - Copyright (c) 2023 The Italian Diabetes Society, the Italian Society for the Study 
      of Atherosclerosis, the Italian Society of Human Nutrition and the Department of 
      Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. 
      All rights reserved.
FAU - Liang, Lin
AU  - Liang L
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Zhao, Xuemei
AU  - Zhao X
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Huang, Liyan
AU  - Huang L
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Tian, Pengchao
AU  - Tian P
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Huang, Boping
AU  - Huang B
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Feng, Jiayu
AU  - Feng J
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Zhou, Ping
AU  - Zhou P
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Wang, Jinxi
AU  - Wang J
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
FAU - Zhang, Jian
AU  - Zhang J
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China; Key 
      Laboratory of Clinical Research for Cardiovascular Medications, National Health 
      Committee, No.167 Beilishi Road, 10037, Beijing, China. Electronic address: 
      fwzhangjian62@126.com.
FAU - Zhang, Yuhui
AU  - Zhang Y
AD  - Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai 
      Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical 
      Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China. 
      Electronic address: yuhuizhangjoy@163.com.
LA  - eng
SI  - ClinicalTrials.gov/NCT02664818
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230111
PL  - Netherlands
TA  - Nutr Metab Cardiovasc Dis
JT  - Nutrition, metabolism, and cardiovascular diseases : NMCD
JID - 9111474
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Body Weight
MH  - *Heart Failure/diagnosis/epidemiology/complications
MH  - *Malnutrition/diagnosis/epidemiology/complications
MH  - Nutrition Assessment
MH  - Nutritional Status
MH  - Prevalence
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - Elder
OT  - Heart failure
OT  - Malnutrition
OT  - Prognosis
COIS- Declaration of competing interest The authors declare no conflict of interest.
EDAT- 2023/01/30 06:00
MHDA- 2023/05/22 06:42
CRDT- 2023/01/29 22:01
PHST- 2022/10/04 00:00 [received]
PHST- 2023/01/02 00:00 [revised]
PHST- 2023/01/05 00:00 [accepted]
PHST- 2023/05/22 06:42 [medline]
PHST- 2023/01/30 06:00 [pubmed]
PHST- 2023/01/29 22:01 [entrez]
AID - S0939-4753(23)00009-1 [pii]
AID - 10.1016/j.numecd.2023.01.004 [doi]
PST - ppublish
SO  - Nutr Metab Cardiovasc Dis. 2023 May;33(5):978-986. doi: 
      10.1016/j.numecd.2023.01.004. Epub 2023 Jan 11.