No abstract

Background: Malnutrition is associated with cardiovascular disease morbidity and mortality. Arrhythmias may be the cardiac consequences of malnutrition Aim: To evaluate the association between prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score and arrhythmic events on 24 hour electrocardiography (ECG) holter recording in patients without manifested arrhythmia. Methods: This study is retrospective analysis of 477 patients who underwent 24 hour ECG holter monitoring. PNI and CONUT score were calculated and patients were divided into tertiles according to PNI and into three groups according to CONUT score; 0: normal, 1-2: mild risk of malnutrition, ≥3: moderate-severe risk of malnutrition. Arrhythmic events were compared between PNI tertiles and CONUT score groups. Results: Total number of premature atrial contractions (PACs), premature ventricular contractions (PVCs), PVC burden and incidence of paroxysmal atrial fibrillation (PAF) were higher in patients within the lowest PNI tertile (p < 0.001, p < 0.001, p < 0.001, p = 0.006, respectively). Total number of PVCs, PVC burden and incidence of PAF were higher in patients with CONUT score ≥3 (p < 0.001, p < 0.001, p < 0.001, respectively). Multivariate analysis showed that PNI was independent predictor of presence of PVC (OR=0.935, 95% CI:0.889-0.982, p = 0.008) and PAF (OR=0.911, 95% CI:0.853-0.972, p = 0.005). Also, CONUT score was independent predictor of presence of PVC (OR=1.181, 95% CI:1.013-1.376, p = 0.034) and PAF (OR=1.211, 95% CI:1.017-1.441, p = 0.032). Incidence of non-sustained ventricular tachycardia did not differ between PNI tertiles or CONUT score groups. Conclusion: Poor nutritional status, assessed by PNI and CONUT score, is associated with arrhythmic events on 24 hour ECG holter recording in patients without manifested arrhythmia.