Tools for the Assessment of the Malnutrition Status and Possible Interventions in Elderly with Cardiovascular Diseases

Tonet, Elisabetta; Campana, Roberta; Caglioni, Serena; Gibiino, Federico; Fiorio, Alessio; Chiaranda, Giorgio; Zagnoni, Silvia; Casella, Gianni; Campo, Gianluca

doi:10.3390/jcm10071508

Cited by 11 publications

(7 citation statements)

References 42 publications

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“…9 This led to development of more comprehensive and objective assessment tools of nutritional status, controlling nutritional status (CONUT) score, prognostic nutritional index (PNI) score, geriatric nutritional risk index (GNRI) score, and mini nutritional assessment (MNA) score, which consider multiple biochemical parameters and anthropometric measurements to provide nutritional status. 10,11 GNRI is strictly designed for elderly patients according to their risk of malnutritional related complications, while CONUT and PNI are applied to all age groups based on biochemical parameters and can detect undernutrition at early stage. 12,13 The CONUT score is calculated based on serum levels of albumin estimating the protein reserve; total cholesterol levels estimating the caloric depletion and total lymphocyte count evaluating the level of impairment in immunity due to undernutrition.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED: Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis

Fang

Zhang

et al. 2022

Scott Med J

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Background and aims COUNT score, PNI score, and GNRI scores are associated with cardiovascular events. This review identifies the most accurate malnutrition assessment tools based on these scores in predicting mortality and readmission outcomes in HF patients. Material and Methods PubMed via MEDLINE, EMBASE were searched to identify studies assessing malnutrition using CONUT, PNI and GNRI. A meta-analysis was carried out to pool the hazard ratios on mortality and readmission rates. The methodological quality was assessed using the Newcastle-Ottawa Scale. Results The mortality in HF patients with malnutrition assessed by CONUT showed pooled HR of 1.23. HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 3.56, 2.71 and 1.57 respectively. For malnutrition assessed with GNRI, HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 4.17, 2.73 and 1.73 respectively. No significance difference in association of CONUT score with pooled HR of readmission rate was observed HR 0.99. With PNI, HF patients with all severe and moderate risk of malnutrition showed mortality with HR 2.14 and HR 1.68 respectively, although they failed to achieve significance. Conclusion CONUT and GNRI are the superior prognostic indicator than PNI in prediction of mortality associated with risk of malnutrition.

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Section: Introductionmentioning

confidence: 99%

RETRACTED: Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis

Fang

Zhang

et al. 2022

Scott Med J

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“…Nevertheless, the clinical benefit of PCI therapy in SCAD patients seems to be limited to the relief of angina, reduction of the incidence of spontaneous myocardial infarction, and improvement of the survival quality of patients, without a significant impact on the long-term prognosis of SCAD patients, i.e., mortality [ 7 , 32 , 33 ], and therefore a large number of investigators are working to find clinical indicators that play an important role in the long-term prognosis of SCAD patients. Previous studies have shown that malnutrition is a common problem among hospitalized patients, and it is estimated that approximately 30-60% of hospitalized patients are at risk for malnutrition, with a higher prevalence in older hospitalized patients [ 14 , 34 ]. The presence of malnutrition risk may further weaken the immune system, and increase the cardiac burden and risk of infection in elderly patients with cardiovascular disease thereby prolonging hospitalization, with negative and far-reaching effects on clinical outcomes in elderly patients with SCAD [ 35 – 37 ].…”

Section: Discussionmentioning

confidence: 99%

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

Kuang,

Qiu,

Yang

et al. 2024

BMC Cardiovasc Disord

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Background Malnutrition increases the risk of poor prognosis in patients with cardiovascular disease, and our current research was designed to assess the predictive performance of the Geriatric Nutrition Risk Index (GNRI) for the occurrence of poor prognosis after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (SCAD) and to explore possible thresholds for nutritional intervention. Methods This study retrospectively enrolled newly diagnosed SCAD patients treated with elective PCI from 2014 to 2017 at Shinonoi General Hospital, with all-cause death as the main follow-up endpoint. Cox regression analysis and restricted cubic spline (RCS) regression analysis were used to explore the association of GNRI with all-cause death risk and its shape. Receiver operating characteristic curve (ROC) analysis and piecewise linear regression analysis were used to evaluate the predictive performance of GNRI level at admission on all-cause death in SCAD patients after PCI and to explore possible nutritional intervention threshold points. Results The incidence of all-cause death was 40.47/1000 person-years after a mean follow-up of 2.18 years for 204 subjects. Kaplan-Meier curves revealed that subjects at risk of malnutrition had a higher all-cause death risk. In multivariate Cox regression analysis, each unit increase in GNRI reduced the all-cause death risk by 14% (HR 0.86, 95% CI 0.77, 0.95), and subjects in the GNRI > 98 group had a significantly lower risk of death compared to those in the GNRI < 98 group (HR 0.04, 95% CI 0.00, 0.89). ROC analysis showed that the baseline GNRI had a very high predictive performance for all-cause death (AUC = 0.8844), and the predictive threshold was 98.62; additionally, in the RCS regression analysis and piecewise linear regression analysis we found that the threshold point for the GNRI-related all-cause death risk was 98.28 and the risk will be significantly reduced when the subjects' baseline GNRI was greater than 98.28. Conclusions GNRI level at admission was an independent predictor of all-cause death in SCAD patients after PCI, and GNRI equal to 98.28 may be a useful threshold for nutritional intervention in SCAD patients treated with PCI.

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“…The Global Leadership Initiative on Malnutrition (GLIM) recommends a two-step approach that involves appraisal of the likelihood of malnutrition and its subsequent identification [ 31 ]. The Mini Nutritional Assessment (MNA) can be used to screen malnutrition [ 32 ]. However, the body mass index (BMI) may also be a useful proxy to assess nutritional status in older patients [ 33 ].…”

Section: Assessment Of Frailtymentioning

confidence: 99%

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

Cacciatore,

Spadafora,

Bernardi

et al. 2023

JCM

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Coronary artery disease (CAD) is highly prevalent in older adults, yet its management remains challenging. Treatment choices are made complex by the frailty burden of older patients, a high prevalence of comorbidities and body composition abnormalities (e.g., sarcopenia), the complexity of coronary anatomy, and the frequent presence of multivessel disease, as well as the coexistence of major ischemic and bleeding risk factors. Recent randomized clinical trials and epidemiological studies have provided new data on optimal management of complex patients with CAD. However, frail older adults are still underrepresented in the literature. This narrative review aims to highlight the importance of assessing frailty as an aid to guide therapeutic decision-making and tailor CAD management to the specific needs of older adults, taking into account age-related pharmacokinetic and pharmacodynamic changes, polypharmacy, and potential drug interactions. We also discuss gaps in the evidence and offer perspectives on how best in the future to optimize the global strategy of CAD management in older adults.

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Tools for the Assessment of the Malnutrition Status and Possible Interventions in Elderly with Cardiovascular Diseases

Cited by 11 publications

References 42 publications

RETRACTED: Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis

RETRACTED: Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis

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

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

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