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Impact of nutritional indices on mortality in patients with heart failure

BACKGROUND: Malnutrition is a common condition that is associated with adverse prognosis in patients with heart failure (HF). The Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI) and controlling nutritional status (CONUT) have all been used as objective indices for evaluat...

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Autores principales: Yoshihisa, Akiomi, Kanno, Yuki, Watanabe, Shunsuke, Yokokawa, Tetsuro, Abe, Satoshi, Miyata, Makiko, Sato, Takamasa, Suzuki, Satoshi, Oikawa, Masayoshi, Kobayashi, Atsushi, Yamaki, Takayoshi, Kunii, Hiroyuki, Nakazato, Kazuhiko, Suzuki, Hitoshi, Ishida, Takafumi, Takeishi, Yasuchika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761292/
https://www.ncbi.nlm.nih.gov/pubmed/29344381
http://dx.doi.org/10.1136/openhrt-2017-000730
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author Yoshihisa, Akiomi
Kanno, Yuki
Watanabe, Shunsuke
Yokokawa, Tetsuro
Abe, Satoshi
Miyata, Makiko
Sato, Takamasa
Suzuki, Satoshi
Oikawa, Masayoshi
Kobayashi, Atsushi
Yamaki, Takayoshi
Kunii, Hiroyuki
Nakazato, Kazuhiko
Suzuki, Hitoshi
Ishida, Takafumi
Takeishi, Yasuchika
author_facet Yoshihisa, Akiomi
Kanno, Yuki
Watanabe, Shunsuke
Yokokawa, Tetsuro
Abe, Satoshi
Miyata, Makiko
Sato, Takamasa
Suzuki, Satoshi
Oikawa, Masayoshi
Kobayashi, Atsushi
Yamaki, Takayoshi
Kunii, Hiroyuki
Nakazato, Kazuhiko
Suzuki, Hitoshi
Ishida, Takafumi
Takeishi, Yasuchika
author_sort Yoshihisa, Akiomi
collection PubMed
description BACKGROUND: Malnutrition is a common condition that is associated with adverse prognosis in patients with heart failure (HF). The Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI) and controlling nutritional status (CONUT) have all been used as objective indices for evaluating nutritional status. We aimed to clarify the relationship between these nutritional indices and the parameters of inflammatory markers, cardiac function and exercise capacity, as well as to compare the ability of these indexes for predicting mortality. METHODS: We evaluated PNI, GNRI and CONUT in consecutive 1307 patients with HF. RESULTS: First, there were significant correlations between nutritional indices and the following: C reactive protein; tumour necrosis factor-α; adiponectin; B-type natriuretic peptide; troponin I; inferior vena cava diameter and peak VO(2) (P<0.05, respectively). Second, in the Kaplan-Meier analysis (follow-up 1146 days), all-cause mortality progressively increased from normal to mild, moderate and severe disturbance groups in the indices (log-rank, P<0.01, respectively). In the Cox proportional hazard analysis, each index was an independent predictor of all-cause mortality in patients with HF (P<0.001, respectively). Third, receiver operating curve demonstrated that the areas under the curve of PNI and GNRI were larger than that of CONUT score (P<0.05, respectively). CONCLUSION: Patients with HF being malnourished had higher mortality accompanied by higher levels of C reactive protein, tumour necrosis factor-α, adiponectin, B-type natriuretic peptide, troponin I, right-sided volume overload and impaired exercise capacity, rather than left ventricular systolic function. Additionally, PNI and GNRI were superior to CONUT score in predicting mortality in patients with HF.
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spelling pubmed-57612922018-01-17 Impact of nutritional indices on mortality in patients with heart failure Yoshihisa, Akiomi Kanno, Yuki Watanabe, Shunsuke Yokokawa, Tetsuro Abe, Satoshi Miyata, Makiko Sato, Takamasa Suzuki, Satoshi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Nakazato, Kazuhiko Suzuki, Hitoshi Ishida, Takafumi Takeishi, Yasuchika Open Heart Heart Failure and Cardiomyopathies BACKGROUND: Malnutrition is a common condition that is associated with adverse prognosis in patients with heart failure (HF). The Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI) and controlling nutritional status (CONUT) have all been used as objective indices for evaluating nutritional status. We aimed to clarify the relationship between these nutritional indices and the parameters of inflammatory markers, cardiac function and exercise capacity, as well as to compare the ability of these indexes for predicting mortality. METHODS: We evaluated PNI, GNRI and CONUT in consecutive 1307 patients with HF. RESULTS: First, there were significant correlations between nutritional indices and the following: C reactive protein; tumour necrosis factor-α; adiponectin; B-type natriuretic peptide; troponin I; inferior vena cava diameter and peak VO(2) (P<0.05, respectively). Second, in the Kaplan-Meier analysis (follow-up 1146 days), all-cause mortality progressively increased from normal to mild, moderate and severe disturbance groups in the indices (log-rank, P<0.01, respectively). In the Cox proportional hazard analysis, each index was an independent predictor of all-cause mortality in patients with HF (P<0.001, respectively). Third, receiver operating curve demonstrated that the areas under the curve of PNI and GNRI were larger than that of CONUT score (P<0.05, respectively). CONCLUSION: Patients with HF being malnourished had higher mortality accompanied by higher levels of C reactive protein, tumour necrosis factor-α, adiponectin, B-type natriuretic peptide, troponin I, right-sided volume overload and impaired exercise capacity, rather than left ventricular systolic function. Additionally, PNI and GNRI were superior to CONUT score in predicting mortality in patients with HF. BMJ Publishing Group 2018-01-09 /pmc/articles/PMC5761292/ /pubmed/29344381 http://dx.doi.org/10.1136/openhrt-2017-000730 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Heart Failure and Cardiomyopathies
Yoshihisa, Akiomi
Kanno, Yuki
Watanabe, Shunsuke
Yokokawa, Tetsuro
Abe, Satoshi
Miyata, Makiko
Sato, Takamasa
Suzuki, Satoshi
Oikawa, Masayoshi
Kobayashi, Atsushi
Yamaki, Takayoshi
Kunii, Hiroyuki
Nakazato, Kazuhiko
Suzuki, Hitoshi
Ishida, Takafumi
Takeishi, Yasuchika
Impact of nutritional indices on mortality in patients with heart failure
title Impact of nutritional indices on mortality in patients with heart failure
title_full Impact of nutritional indices on mortality in patients with heart failure
title_fullStr Impact of nutritional indices on mortality in patients with heart failure
title_full_unstemmed Impact of nutritional indices on mortality in patients with heart failure
title_short Impact of nutritional indices on mortality in patients with heart failure
title_sort impact of nutritional indices on mortality in patients with heart failure
topic Heart Failure and Cardiomyopathies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761292/
https://www.ncbi.nlm.nih.gov/pubmed/29344381
http://dx.doi.org/10.1136/openhrt-2017-000730
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