Abstract 9789: Geriatric Nutritional Risk Index Predicts Bleeding Event in Patients With Heart Failure

Abstract

Introduction: The relationship between malnutrition and bleeding event has been unclear in patients with heart failure (HF). Method and Results: We evaluated the nutritional status of patients with HF (n = 2,044) using Geriatric Nutritional Risk Index (GNRI). The primary endpoint was composite bleeding event of hemorrhagic stroke or gastrointestinal bleeding. According to the survival classification and regression tree analysis, the accurate cut-off point of GNRI for predicting the primary endpoint was 106.2. We divided patients into two groups based on GNRI levels: the High GNRI group (GNRI ≥ 106.2, n = 606, 29.6%) and the Low GNRI group (GNRI < 106.2, n = 1,438, 70.4%), and compared patients’ characteristics and prognosis between the two groups. The Low GNRI group showed higher age (72.0 vs. 63.0 years, P < 0.001) and lower prevalence of male sex (56.9% vs. 64.5%, P = 0.001) than the High GNRI group. There were no differences in use of antiplatelet agents and anticoagulants between the groups. In laboratory data, levels of B-type natriuretic peptide were higher in the Low GNRI group (321.1 vs. 111.6 pg/mL, P < 0.001). Left ventricular ejection fraction was comparable between the groups. The Kaplan-Meier analysis demonstrated that bleeding event rates were higher in the Low GNRI group than in the High GNRI group (Figure, log-rank P < 0.001). The multivariable Cox proportional hazard analysis revealed that the Low GNRI was independently associated with bleeding events (hazard ratio 1.795, P = 0.047). Conclusions: Malnutrition assessed by GNRI predicts bleeding events in patients with HF.