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Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction

Background: Malnutrition is a frequent condition in the elderly, and is associated with prolonged hospitalization and increased mortality. However, the impacts of malnutrition among elderly patients with acute myocardial infarction have not been clarified yet. Methods and Results: We enrolled 174 pa...

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Autores principales: Komici, Klara, Vitale, Dino Franco, Mancini, Angela, Bencivenga, Leonardo, Conte, Maddalena, Provenzano, Sandra, Grieco, Fabrizio Vincenzo, Visaggi, Lucia, Ronga, Ilaria, Cittadini, Antonio, Corbi, Graziamaria, Trimarco, Bruno, Morisco, Carmine, Leosco, Dario, Ferrara, Nicola, Rengo, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412515/
https://www.ncbi.nlm.nih.gov/pubmed/30678180
http://dx.doi.org/10.3390/nu11020224
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author Komici, Klara
Vitale, Dino Franco
Mancini, Angela
Bencivenga, Leonardo
Conte, Maddalena
Provenzano, Sandra
Grieco, Fabrizio Vincenzo
Visaggi, Lucia
Ronga, Ilaria
Cittadini, Antonio
Corbi, Graziamaria
Trimarco, Bruno
Morisco, Carmine
Leosco, Dario
Ferrara, Nicola
Rengo, Giuseppe
author_facet Komici, Klara
Vitale, Dino Franco
Mancini, Angela
Bencivenga, Leonardo
Conte, Maddalena
Provenzano, Sandra
Grieco, Fabrizio Vincenzo
Visaggi, Lucia
Ronga, Ilaria
Cittadini, Antonio
Corbi, Graziamaria
Trimarco, Bruno
Morisco, Carmine
Leosco, Dario
Ferrara, Nicola
Rengo, Giuseppe
author_sort Komici, Klara
collection PubMed
description Background: Malnutrition is a frequent condition in the elderly, and is associated with prolonged hospitalization and increased mortality. However, the impacts of malnutrition among elderly patients with acute myocardial infarction have not been clarified yet. Methods and Results: We enrolled 174 patients aged 65 years and over, admitted with the diagnosis of acute myocardial infarction (AMI), who underwent evaluation of nutritional status by Mini Nutritional Assessment (MNA) and evaluation of mortality risk by GRACE Score 2.0. All-cause mortality was the outcome considered for this study. Over a mean follow-up of 24.5 ± 18.2 months, 43 deaths have been registered (24.3%). Non-survivors were more likely to be older, with worse glomerular filtration rate, lower systolic blood pressure, lower albumin and MNA score, higher prevalence of Killip classification III-IV grade, and higher Troponin I levels. Multivariate Cox proportional analysis revealed that GRACE Score and MNA showed a significant and independent impact on mortality, (HR = 1.76, 95%, CI = 1.34–2.32, and HR = 0.56, 95% CI = 0.42–0.73, respectively). Moreover, the clinical decision curve revealed a higher clinical net benefit when the MNA was included, compared to the partial models without MNA. Conclusion: Nutritional status is an independent predictor of long-term mortality among elderly patients with AMI. MNA score in elderly patients with AMI may help prognostic stratification and identification of patients with, or at risk of, malnutrition in order to apply interventions to improve nutritional status, and maybe survival in this population.
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spelling pubmed-64125152019-03-29 Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction Komici, Klara Vitale, Dino Franco Mancini, Angela Bencivenga, Leonardo Conte, Maddalena Provenzano, Sandra Grieco, Fabrizio Vincenzo Visaggi, Lucia Ronga, Ilaria Cittadini, Antonio Corbi, Graziamaria Trimarco, Bruno Morisco, Carmine Leosco, Dario Ferrara, Nicola Rengo, Giuseppe Nutrients Article Background: Malnutrition is a frequent condition in the elderly, and is associated with prolonged hospitalization and increased mortality. However, the impacts of malnutrition among elderly patients with acute myocardial infarction have not been clarified yet. Methods and Results: We enrolled 174 patients aged 65 years and over, admitted with the diagnosis of acute myocardial infarction (AMI), who underwent evaluation of nutritional status by Mini Nutritional Assessment (MNA) and evaluation of mortality risk by GRACE Score 2.0. All-cause mortality was the outcome considered for this study. Over a mean follow-up of 24.5 ± 18.2 months, 43 deaths have been registered (24.3%). Non-survivors were more likely to be older, with worse glomerular filtration rate, lower systolic blood pressure, lower albumin and MNA score, higher prevalence of Killip classification III-IV grade, and higher Troponin I levels. Multivariate Cox proportional analysis revealed that GRACE Score and MNA showed a significant and independent impact on mortality, (HR = 1.76, 95%, CI = 1.34–2.32, and HR = 0.56, 95% CI = 0.42–0.73, respectively). Moreover, the clinical decision curve revealed a higher clinical net benefit when the MNA was included, compared to the partial models without MNA. Conclusion: Nutritional status is an independent predictor of long-term mortality among elderly patients with AMI. MNA score in elderly patients with AMI may help prognostic stratification and identification of patients with, or at risk of, malnutrition in order to apply interventions to improve nutritional status, and maybe survival in this population. MDPI 2019-01-22 /pmc/articles/PMC6412515/ /pubmed/30678180 http://dx.doi.org/10.3390/nu11020224 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Komici, Klara
Vitale, Dino Franco
Mancini, Angela
Bencivenga, Leonardo
Conte, Maddalena
Provenzano, Sandra
Grieco, Fabrizio Vincenzo
Visaggi, Lucia
Ronga, Ilaria
Cittadini, Antonio
Corbi, Graziamaria
Trimarco, Bruno
Morisco, Carmine
Leosco, Dario
Ferrara, Nicola
Rengo, Giuseppe
Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title_full Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title_fullStr Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title_full_unstemmed Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title_short Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction
title_sort impact of malnutrition on long-term mortality in elderly patients with acute myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412515/
https://www.ncbi.nlm.nih.gov/pubmed/30678180
http://dx.doi.org/10.3390/nu11020224
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