Abstract 13504: Geriatric Nutritional Risk Index Predict Cardiovascular Events in Patients at Risk for Heart Failure

Abstract

Introduction: Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly patients. Lower GNRI is associated with a worse prognosis in patients with heart failure (HF) with preserved ejection fraction. However, few data are available regarding the prognostic impact of GNRI value for risk stratification in patients at risk for HF, classified as stage A/B according to the ACC/AHA HF guidelines. Hypothesis: We hypothesized that GNRI values would predict adverse cardiovascular (CV) events, even in patients without prior HF. Methods: We retrospectively enrolled 2258 consecutive patients without prior HF who were hospitalized for CV diseases between 2005 and 2012. GNRI on admission was calculated as follows: 14.89 х serum albumin (g/dL) + 41.7 х body mass index/22. Patients were divided into two groups stratified by GNRI (median value 106.7). The study endpoint was the composite of CV death and hospitalization for worsening HF. Results: Over a 4.6-year median follow-up, adverse events were observed in 139 patients (6.2 %). In Kaplan–Meier analysis, patients with low GNRI (< 106.7, n = 1128) showed worse prognoses than those with high GNRI (≥ 106.7, n = 1130) (8.1 % vs. 4.2 %, P < 0.001). In multivariate Cox proportional hazards analysis after the adjustment for age, sex, estimated glomerular filtration rate, B-type natriuretic peptide, and left ventricular ejection fraction, Low GNRI (<106.7) was significantly associated with the incidence of CV events (hazard ratio: 1.72, 95% confidence interval: 1.26–2.35; P = 0.001). Conclusions: In patients without prior HF, GNRI is an independent predictor of CV events. Simple assessment of GNRI may be useful for predicting CV events in those patients.