Malnutrition in patients with chronic heart failure

Abstract Background Malnutrition is highly common in patients with chronic heart failure and often overlooked. It can accelerate disease progression by activating cytokines, causing autonomic dysfunction cachexia. If malnutrition detected early, physicians may be able to identify who are at high risk for an adverse outcome. assessed according scores, like the prognostic nutritional index [PNI: albumin (g/L) + 5×total lymphocyte count ×109/L)], controlling status [CONUT: sum of albumin, cholesterol count] geriatric [GNRI: (1.489×albumin (g/L)) 41.7×(weight/ideal weight)]. Objectives Our aim assess prevalence malnutrition, expressed PNI, GNRI CONUT across spectrum HF investigate whether these scores associated Methods In total, 9733 consecutive were included this study. Patients classified into one three subtypes based on guideline diagnostic criteria: reduced (HFrEF; LVEF <40%), mildly (HFmrEF; 40–49%), or preserved ejection fraction (HFpEF; ≥50). was GNRI, (PNI: Malnutrition<45, absent≥45/ GNRI: <82 severe; 82–91 moderate; 92–98 mild; >98 normal/CONUT: 9–12 5–8 2–4 0–1 normal). The association between respective all-cause mortality assessed. Results Of included, 5680 (58.4%) diagnosed HFpEF, 2214 (22.7%) HFmrEF, 1839 (18.9%) HFrEF. Overall, median BMI 27.5 (IQR 24.5–31.2), 33% participants female, age 70 years 61–77). 40%, 42%, 63% defined as malnourished CONUT, respectively. During a follow-up time 3.71 1.56–6.32) total 3159 (32.5%) deaths observed. Malnutrition, indicated low PNI score, worse survival HR 2.53 [2.35–2.71], 1.60 [1.55–1.66], CONUT: 1.841 [1.76–1.9], p<0.001 all). This remained significant after adjustment age, sex, kidney NT-proBNP (adj. HR, 1.41 (1.35–1.46), PNI: 1.86 (1.72–2.01), 1.52 (1.45–1.60) Interaction analysis confirmed that independent from type all (p=ns Figure1 displays curves score categories (p<0.001 all, log-rank test). Conclusion failure. higher rates, irrespective classical confounder models even NTproBNP. Based their additional value, could routine examination patients. Funding Acknowledgement Type funding sources: None.