Abstract
Background: Nutritional abnormalities are common among patients with chronic heart failure (CHF). However, little is known regarding clinical implication to evaluate the nutritional status in CHF patients. In this study, we examined the prognostic impact of nutrition-related factors, including serum albumin level (ALB), total lymphocyte count (TLC), and body mass index (BMI) in patients with CHF. Methods: We prospectively enrolled 280 stable patients with stage-C/D CHF since February 2000. Kaplan-Meier analyses and multivariate Cox regression analyses were performed to evaluate the association between the mortality and the nutrition-related factors mentioned above. Covariables used in the multivariate models were ALB, TLC, BMI, hemoglobin concentration, left ventricular ejection fraction, etiology of CHF, serum creatinine level, and age at the entry. Results: The mean age of the study population was 61.2±14.9 years and the mean follow-up period was 2.4±1.5 years. Kaplan-Meier analyses showed that the incidences of all-cause mortality were significantly higher in patients with lower ALB, lower TLC, or lower BMI as compared those without the nutritional abnormalities (Figure ). Multivariate analyses revealed that higher TLC was an independent significant predictor of freedom from cardiac-cause death (HR 0.9993, p=0.016) and higher ALB was significantly associated with increased survival (HR 0.563, p=0.03). Conclusions: The evaluation of nutritional status may be a powerful and cost-effective tool in predicting the mortality of patients with CHF. Further research is necessary to evaluate the importance of nutritional improvement in such patients.
Published Version
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