Prognostic impact of a novel index of nutrition and inflammation for patients with acute decompensated heart failure

Maeda, Daichi; Kanzaki, Yumiko; Sakane, Kazushi; Ito, Takahide; Sohmiya, Koichi; Hoshiga, Masaaki

doi:10.1007/s00380-020-01590-4

Cited by 24 publications

(24 citation statements)

References 34 publications

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“…Malnutrition is a common complication of several chronic illnesses, and it could accelerate the progression of the disease as part of a vicious cycle relevant to cytokine activation ( 1 – 4 ). Previous studies have shown that malnutrition is an important poor prognostic factor for chronic heart failure (HF) ( 5 ), advanced heart failure (AHF) ( 3 ), acute decompensated heart failure (ADHF) ( 6 ), and preserved ejection fraction (HFpEF) ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Association of Malnutrition, Left Ventricular Ejection Fraction Category, and Mortality in Patients Undergoing Coronary Angiography: A Cohort With 45,826 Patients

et al. 2021

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Background: The regulatory effect of the left ventricular ejection fraction (LVEF) categories on the association of malnutrition and all-cause mortality in patients undergoing coronary angiography (CAG) have not been adequately addressed.Methods: Forty-five thousand eight hundred and twenty-six patients consecutively enrolled in the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936) from January 2008 to July 2018 who underwent coronary angiography (CAG). The Controlling Nutritional Status (CONUT) score was applied to 45,826 CAG patients. The hazard ratios of mortality across combined LVEF and/or malnutrition categories were estimated by Cox regression models. Variables adjusted for in the Cox regression models included: age, gender, hypertension (HT), DM, PCI, coronary artery disease (CAD), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TRIG), chronic kidney disease (CKD), statins, atrial fibrillation (AF), anemia, and stroke. Population attributable risk (PAR) was estimated for eight groups stratified by nutritional status and LVEF categories.Results: In our study, 42,181(92%) of patients were LVEF ≥ 40%, of whom, 41.55 and 9.34% were in mild and moderate or severe malnutrition status, respectively, while 46.53 and 22.28% in mild and moderate or severe malnutritional status among patients with LVEF < 40%. During a median follow-up time of 4.5 years (percentile 2.8–7.1), 5,350 (11.7%) patients died. After fully adjustment, there is no difference of mortality on malnutrition in LVEF < 40% group (mild, moderate and severe vs. normal, HR (95%CI): [1.00 (0.83–0.98)], [1.20 (0.95–1.51)], [1.41 (0.87–2.29)], respectively, p for trend =0.068), but malnutrition was related to markedly increased risk of mortality in LVEF ≥ 40% group (mild, moderate, and severe vs. normal, HR (95%CI): [1.21 (1.12–1.31)], [1.56 (1.40–1.74)], and [2.20(1.67–2.90)], respectively, p for trend < 0.001, and p for interaction < 0.001). Patients with LVEF ≥ 40% had a higher malnutrition-associated risk of mortality and a higher PAR than those with LVEF < 40%.Conclusions: Malnutrition is common in CAG patients and it has a greater effect on all-cause mortality and a higher PAR in patients with LVEF ≥ 40% than LVEF < 40%.

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Section: Introductionmentioning

confidence: 99%

Association of Malnutrition, Left Ventricular Ejection Fraction Category, and Mortality in Patients Undergoing Coronary Angiography: A Cohort With 45,826 Patients

et al. 2021

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“…In addition, more and more studies have integrated nutrition and inflammation to assess disease development and prognosis ( 29 – 31 ). Importantly, ALI, a comprehensive evaluation index based on nutrition and inflammation, was associated with poor prognosis in several types of cancers, as well as in heart failure ( 10 , 13 , 32 , 33 ). Hypertension is well-known to trigger incident heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…It was originally used to assess inflammation and nutritional status in lung cancer patients and has been associated with all-cause mortality in lung cancer patients ( 10 ). ALI has since been promoted for many diseases that are also affected by both nutrition and inflammation, such as Crohn’s disease ( 11 ), coronary artery disease ( 12 ) and heart failure ( 13 ). Hypertension is also affected by nutrition and inflammation ( 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

The advanced lung cancer inflammation index predicts long-term outcomes in patients with hypertension: National health and nutrition examination study, 1999–2014

Zhang

Pan²,

Tu³

et al. 2022

Front. Nutr.

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BackgroundMalnutrition and systemic inflammation are associated with poor outcomes in patients with hypertension, and the two often coexist. However, few studies have combined nutritional and inflammatory status to assess the prognosis of patients with hypertension. The present study aimed to investigate the association between advanced lung cancer inflammation index (ALI), as a factor assessment the nutritional and inflammatory status, and long-term all-cause mortality of patients with hypertension.Materials and methodsData from the National Health and Nutrition Examination Survey (NHANES) 1999–2014 with mortality follow-up through December 31, 2015, were analyzed. A total of 15,681 participants were evaluated. The patients were grouped based on the ALI tertiles as follows: T1 (ALI ≤ 49.41, n = 5,222), T2 (ALI > 49.41 and ≤ 76.29, n = 5,221), and T3 (ALI > 76.29, n = 5,237) groups. Survival curves and Cox regression analysis based on the NHANES recommended weights were used to assess the relationship between nutritional and inflammatory status and long-term all-cause mortality.ResultsAdvanced lung cancer inflammation index was significantly associated with long-term all-cause mortality in patients with hypertension. After adjustment for related factors, the T2 [hazard ratio (HR): 0.69, 95% confidence interval (CI): 0.58–0.83; P < 0.001) and T3 (HR: 0.59, 95% CI: 0.47–0.74; P < 0.001) groups were significantly associated with a decreased risk of all-cause mortality compared to the lower ALI level group (T1).ConclusionAdvanced lung cancer inflammation index was a comprehensive index of nutrition and inflammation and an independent significant prognostic factor in hypertension patients in the American community. Systemic inflammatory and nutritional status assessment and monitoring are essential for the health of hypertensive patients.

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“…Malnutrition is commonly prevalent in CHF, with a reported incidence of 7.5 and 57% in severe or moderate malnutrition, respectively ( 23 ). These patients are older and frail, with negative calorie and nitrogen balance and energy availability ( 24 ) for physical activity, and are triggered by multiple factors such as anorexia, malabsorption secondary to intestinal edema, high energy demand, and cytokine-induced hypercatabolism ( 7 , 25 ) and worse outcomes ( 6 , 26 , 27 ). However, when compared with CHF participants with BMI < 30 kg/m 2 , participants with BMI ≥ 30 kg/m 2 did not show a distinct increase in energy and macronutrient intake.…”

Section: Discussionmentioning

confidence: 99%

Congestive Heart Failure Exhibited Higher BMI With Lower Energy Intake and Lower Physical Activity Level: Data From the National Health and Examination Nutrition Survey

Zhou

et al. 2021

Front. Cardiovasc. Med.

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Background: Despite that nutritional deficiency existed in congestive heart failure (CHF), there is a large amount of CHF patients suffering from obesity. This study aimed to identify the differences for increased BMI or obesity in CHF patients.Methods: This cross-sectional study included adults from the National Health and Nutrition Examination Survey 2007–2016. Differences were compared between CHF participants vs. non-CHF participants, and BMI ≥ 30 kg/m2 vs. BMI < 30 kg/m2 CHF participants.Results: CHF participants were with higher BMI, lower energy and macronutrient intake, lower physical activity level and longer rest time, and lower hematocrit and hemoglobin level (all P < 0.05) than non-CHF participants. The prevalence of BMI ≥ 30 kg/m2 in participants with CHF was 53.48%. There was no significant difference observed in energy and macronutrient intake between CHF participants with BMI ≥ 30 kg/m2 or <30 kg/m2. The water intake (P = 0.032), sedentary time (P = 0.002), and hematocrit (P = 0.028) were significantly different between CHF with BMI ≥ 30 kg/m2 and with <30 kg/m2.Conclusion: Compared with non-CHF participants, CHF participants exhibited higher BMI with lower energy and macronutrient intake, lower physical activity level, longer rest time, and hemodilution with lower hematocrit and hemoglobin level. Among CHF participants with BMI ≥ 30 kg/m2, higher sedentary time and hematocrit were observed.

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Prognostic impact of a novel index of nutrition and inflammation for patients with acute decompensated heart failure

Cited by 24 publications

References 34 publications

Association of Malnutrition, Left Ventricular Ejection Fraction Category, and Mortality in Patients Undergoing Coronary Angiography: A Cohort With 45,826 Patients

Association of Malnutrition, Left Ventricular Ejection Fraction Category, and Mortality in Patients Undergoing Coronary Angiography: A Cohort With 45,826 Patients

The advanced lung cancer inflammation index predicts long-term outcomes in patients with hypertension: National health and nutrition examination study, 1999–2014

Congestive Heart Failure Exhibited Higher BMI With Lower Energy Intake and Lower Physical Activity Level: Data From the National Health and Examination Nutrition Survey

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