Predicting One-Year Deaths and Major Adverse Vascular Events with the Controlling Nutritional Status Score in Elderly Patients with Non–ST-Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Kalyoncuoğlu, Muhsin; Katkat, Fahrettin; Biter, Halil İbrahim; Çakal, Sinem; Tosu, Aydın Rodi; Can, Mehmet Mustafa

doi:10.3390/jcm10112247

Cited by 18 publications

(21 citation statements)

References 36 publications

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“…After a more detailed review,48 references were excluded for different reasons. For the final analysis, nine ( 13 , 24 , 25 , 29 – 34 ) observational studies were included.…”

Section: Resultsmentioning

confidence: 99%

“…The lower level of the laboratory variables used to calculate the CONUT score has shown to be associated with disease progression and mortality in patients with CAD ( 18 – 23 ). Furthermore, when compared to other nutrition-related measures in patients with CAD, recent studies have demonstrated that the CONUT score has the highest predictive ability for mortality and MACE ( 24 , 25 ). However, no previous meta-analysis has specifically addressed the predictive value of CONUT score for all-cause mortality and MACE in this population group.…”

Section: Introductionmentioning

confidence: 99%

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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

Arero

Mohammed

et al. 2022

Front. Nutr.

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BackgroundAs 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).MethodsObservational 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.ResultsOf 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.ConclusionAs 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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“…After a more detailed review,48 references were excluded for different reasons. For the final analysis, nine ( 13 , 24 , 25 , 29 – 34 ) observational studies were included.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Arero

Mohammed

et al. 2022

Front. Nutr.

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“…Several nutritional scoring systems, including the prognostic nutritional index (PNI), CONUT, triglycerides-total cholesterol-body weight index (TCBI), Mini Nutritional Assessment (MSA), Graz Malnutrition Screening (GMS), and GNRI have been introduced for evaluating nutritional state in clinical practice. Malnutrition determined by the PNI ( 23 ), TCBI ( 24 , 25 ), and CONUT ( 3 ) was also significantly associated with adverse outcomes in patients with CAD ( 23 ). However, there is no consensus on which tools have the best predictive role in patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies ( 7 – 11 ) have investigated the associations of GNRI with adverse outcomes in patients with CAD. However, the predictive value of GNRI was not fully established in this population due to the presence of conflicting results ( 3 , 12 ).…”

Section: Introductionmentioning

confidence: 92%

“…Despite the prevalence of nutritional deficiency remaining unclear in patients with coronary artery disease (CAD), malnutrition was reported to be at 38.7% with Controlling Nutritional status (CONUT) scores and 64% with GNRI scores among non-ST-elevated myocardial infarction (NSTEMI) ( 3 ). Poor nutritional status in patients with CAD is associated with unfavorable outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Value of Geriatric Nutritional Risk Index in Patients With Coronary Artery Disease: A Meta-Analysis

Fan

Zhou

et al. 2021

Front. Nutr.

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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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Cut-off values of Geriatric Nutritional Risk Index for cardiovascular events in Japanese patients with acute myocardial infarction

Ito,

Inoue,

Nagoshi

et al. 2024

Heart Vessels

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The Geriatric Nutritional Risk Index (GNRI) is a straightforward nutritional risk assessment tool with an established relationship with poor prognosis in patients with heart failure. However, the utility of the GNRI in patients with acute myocardial infarction (AMI) remains unclear given the time-dependent changes in the pathophysiology of AMI and the selected endpoints. Accordingly, we aimed to evaluate the optimal cut-off values of the GNRI for cardiovascular events in patients with AMI. We used time-dependent receiver operating characteristic analysis to identify the optimal cut-off values for two endpoints, all-cause death and major adverse cardiac events (MACE: all-cause death, non-fatal myocardial infarction, hospitalization for heart failure, and stroke), over 4 years in 360 patients with AMI between 2012 and 2020. The cumulative incidence of MACE was 11.6%. The cut-off value of the GNRI for all-cause death was 82.7 (area under the curve [AUC], 0.834) at 3 months and 90.3 (AUC 0.854) at 4 years. The cut-off value of the GNRI for MACE was 83.0 (AUC 0.841) at 3 months and 95.3 (AUC 0.821) at 4 years. The GNRI demonstrated consistently high reliability relative to other indicators of AMI. Our findings indicated that the optimal cut-off value and reliability of the GNRI for cardiovascular events varied according to the endpoints and observation periods. GNRI emerges as a crucial predictor of prognosis for patients with AMI.

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Predicting One-Year Deaths and Major Adverse Vascular Events with the Controlling Nutritional Status Score in Elderly Patients with Non–ST-Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Cited by 18 publications

References 36 publications

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

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

Predictive Value of Geriatric Nutritional Risk Index in Patients With Coronary Artery Disease: A Meta-Analysis

Cut-off values of Geriatric Nutritional Risk Index for cardiovascular events in Japanese patients with acute myocardial infarction

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