Influence of nutritional status on early outcomes of elderly patients admitted with acute myocardial infarction

Abstract

Background: The impact of malnutrition on early outcomes has not been studied widely in acute myocardial infarction (AMI). This study aimed at determining the effect of malnutrition on in-hospital mortality or duration of hospital stay in the elderly AMI patient. Method: Data from the Tokai Acute Myocardial Infarction Study II were used. This was a prospective study of all patients admitted to 15 hospitals with AMI. We abstracted the baseline and procedural characteristics, serum albumin level, and in-hospital mortality from detailed chart reviews. Patients aged 65 and over were stratified into two groups according to serum albumin concentration. Results: The present analysis included a subsample of 629 patients with serum albumin concentration <35 g/L (undernutrition group) and 962 patients with serum albumin concentration ≥35 g/L (normal nutrition group). Patients in the undernutition group were older, more likely to be dependent in activities of daily living, and have a lower systolic blood pressure or a lower body mass index score, a history of renal failure, and signs of heart failure on presentation. Also, patients in this group frequently had a reduced left ventricular function and multivessel coronary disease. They were more likely to receive vasopressors, intra-aortic balloon pump, or mechanical ventilation, and were less likely to receive percutaneous coronary intervention. Although undernutrition group patients had a significantly higher mortality rate or a longer duration of stay than normal nutrition group patients, the differences disappeared after multivariable adjustment. Conclusions: Malnutrition of elderly AMI patients was not associated with poor early outcomes.