Abstract
BackgroundWe investigated the role of nutritional risk index (NRI) in predicting 1-year mortality in patients with acute decompensated heart failure (ADHF).MethodsAmong 5,625 cohort patients enrolled in Korean Acute Heart Failure (KorAHF) Registry, a total of 5,265 patients who were possible to calculate NRI [NRI = (1.519 x serum albumin [g/dl]) + (41.7 x weight [kg]/ideal body weight [kg])] were enrolled. The patients were divided into 4 groups according to the NRI quartile; Q1 <89 (n = 1121, 69.9 ± 14.5 years, 632 males), Q2 89–95 (n = 1234, 69.7 ± 14.4 years, 677 males), Q3 95–100 (n = 1199, 68.8 ± 14.0 years, 849 males), Q4 >100 (n = 1711, 65.6 ± 14.5 years, 779 males). Primary end-point was all-cause mortality at 1-year clinical follow-up.ResultsThe 1-year mortality was significantly increased as the NRI quartile decreased, and the lowest NRI quartile was associated with the highest 1-year mortality (Q1: 27.5% vs. Q2: 20.9% vs. Q3: 12.9% vs. Q4: 8.7%, linear p <0.001). On Kaplan-Meier survival analysis, the significant inter-quartile difference was observed (p <0.001 for all). In multivariate analysis using Cox proportional hazard regression, the lowest NRI quartile was an independent predictor of 1-year mortality in patients with ADHF.ConclusionsPoor nutritional status as assessed by NRI and quartile grading of NRI was associated with 1-year mortality in Korean patients with ADHF. The assessment of nutritional status by NRI may provide additional prognostic information and thus would be useful in the risk stratification of the patients with ADHF.
Highlights
Nutrition has been an essential risk factor in various cardiovascular diseases
Poor nutritional status as assessed by nutritional risk index (NRI) and quartile grading of NRI was associated with 1-year mortality in Korean patients with acute decompensated heart failure (ADHF)
The previous studies have shown that albumin or body mass index (BMI) which can reflect a nutritional status is associated with adverse clinical outcomes in various cardiovascular diseases [5,6,7,8,9]
Summary
Nutrition has been an essential risk factor in various cardiovascular diseases. There are numbers of evidences that nutritional status affects development of heart failure (HF) as well as its clinical outcomes. An imbalance between anabolic and catabolic processes in patients with HF can cause malnutrition [3] Despite these close association between nutritional status and HF, there is a difficulty in the diagnosis of malnutrition and cachexia in patients with HF because of body weight gain due to edema or excessive extracellular fluid in this clinical setting.[4]. The previous studies have shown that albumin or body mass index (BMI) which can reflect a nutritional status is associated with adverse clinical outcomes in various cardiovascular diseases [5,6,7,8,9]. We investigated the role of nutritional risk index (NRI) in predicting 1-year mortality in patients with acute decompensated heart failure (ADHF)
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