Prevalence and prognostic significance of malnutrition in patients with acute coronary syndrome treated with percutaneous coronary intervention

Abstract

The incidence and impact of malnutrition on acute coronary syndrome (ACS) remain unclear. This study aimed to evaluate the prevalence, clinical relevance, and prognostic outcomes of malnutrition in patients with ACS treated with percutaneous coronary intervention. This retrospective study included 1930 consecutive patients with ACS undergoing percutaneous coronary intervention and assessed their nutritional status using 3 scoring systems: Controlling Nutritional Status score, nutritional risk index (NRI), and prognostic nutritional index (PNI). The primary endpoint was all-cause mortality. The Controlling Nutritional Status, NRI, and PNI scores showed that 5.2%, 17.5%, and 3.9% of patients were moderately or severely malnourished, respectively. During a median follow-up of 67.2 months (interquartile range: 46.8–88.5 months), 74 (3.8%) patients died. Malnutrition was associated with a significantly increased risk for all-cause mortality compared with good nutrition (adjusted hazard ratios for moderate and severe malnutrition, respectively: 5.65 [95% confidence interval: 3.27–9.78] and 15.26 [7.50–31.05] for the NRI score, 5.53 [2.10–14.49] and 11.08 [5.69–21.59] for the PNI; P < .001). The current findings demonstrated that malnutrition is prevalent among patients with ACS and is closely associated with increased mortality. Further study is needed to evaluate the effects of nutritional interventions on the outcomes of patients with ACS.

Management of Coronary Artery Disease in Older Adults: Recent Advances and Gaps in Evidence

“…The multidimensional assessment can be further deepened through the evaluation of the impact of comorbidities (e.g., Cumulative Illness Rating Scale for Geriatric Patients [ 15 ]), disability and functional status (e.g., activities of daily living and instrumental activities of daily living scores [ 16 ], Barthel Index [ 17 ]), cognitive status (e.g., Mini Mental State Examination [ 18 ], Montreal Cognitive Assessment [ 19 ], Short Portable Mental Status Questionnaire [ 20 ]), as well as sarcopenia and physical performance. The latter are relevant metrics to assess overall health and predict outcomes and, as such, should be part of a multidimensional evaluation [ 21 , 22 ]. Sarcopenia—the loss of skeletal muscle mass, strength and function [ 23 ]—is a powerful predictor of CVD progression, falls, reduced quality of life, and death in patients with CVD [ 24 , 25 , 26 , 27 , 28 ].…”

Prognostic value of geriatric nutritional risk index in patients with stable coronary artery disease undergoing percutaneous coronary intervention

“…PCI is, currently, one of the main invasive treatments for patients with CAD, which can effectively relieve myocardial ischemia and improve myocardial oxygenation, and reduce angina attacks and myocardial infarction [ 7 , 8 ]. Previous studies have shown that the presence of malnutrition may increase the incidence of post-PCI complications and cardiovascular events in elderly SCAD patients, which has a significant impact on the long-term prognosis of patients [ 9 , 10 ]; in addition, malnutrition can induce a chronic inflammatory response in the body, and long-term chronic inflammation can further aggravate malnutrition and oxidative stress, thereby exacerbating endothelial dysfunction and forming a malnutrition-inflammation-atherosclerosis syndrome [ 11 , 12 ]. Therefore, evaluating the nutritional conditions of elderly SCAD patients undergoing PCI during hospitalization may have important prognostic implications.…”

Geriatric nutritional risk index predicts all-cause mortality in the oldest-old patients with acute coronary syndrome: A 10-year cohort study

“…Recently, the side effects of malnutrition in cardiovascular diseases have come under the researchers' spotlight. Clinical studies have demonstrated that malnutritional status has negative effects on people affected by cardiovascular diseases including ACS (13)(14)(15)(16).…”