P2526Association between preoperative nutritional status and clinical outcomes of patient with coronary artery disease undergoing percutaneous coronary intervention

Abstract

Abstract Background Malnutrition is associated with poor outcomes in patients with cancer, heart failure and chronic kidney disease. Different nutritional assessment tools have been developed to provide a better screening tool for malnutrition status evaluation. The prognostic significance of the Controlling Nutritional Status (CONUT) score has been widely used but has limited information for the predictive value in coronary artery disease (CAD) patients. Methods We conducted a cohort which enrolled 3118 patients with CAD undergoing percutaneous coronary intervention (PCI) from 2005 to 2015. Nutritional status was evaluated using the CONUT score which comprises of serum albumin and total cholesterol levels, and total lymphocyte count. Higher scores reflect worse nutritional status. The patients were classified as normal (0–1), mildly (2–4), moderately (5–8), or severely malnourished (9–12) based on the CONUT score. The association between nutritional status and future events including acute myocardial infarction (AMI), ischemic stroke, revascularization, congestive heart failure, major adverse cardiovascular events (CV death, stroke and AMI) and total cardiovascular events were evaluated. Results 81.5% of our patients were male, and the mean age was 71.5±12.1 years. The mean CONUT score was 2.6. Patients with higher COUNT score were older, have lower body weight, BMI, lower LDL-C values and worse renal function. The Kaplan-Meier analysis revealed patients with high CONUT score was significantly associated with higher rates of the major event including MACE (log-rank P<0.001), acute myocardial infarction (P<0.001), cardiovascular death (P<0.001), congestive heart failure (P<0.001) and total CV events (log-rank P<0.001). After adjusting for comorbidities and medication, increasing CONUT score was independently associated with higher risk of developing AMI (HR: 1.13; 95% CI 1.03–1.24, P=0.008); CV death (HR: 1.18, 95% CI: 1.07–1.30, P=0.001); CHF (HR: 1.11, 95% CI: 1.04–1.18, P=0.002); MACE: (HR: 1.14, 95% CI: 1.07–1.22, P<0.001) and total CV events (HR: 1.11, 95% CI: 1.07–1.15, P<0.001). The subgroup analyses demonstrated that the association of CONUT score existed independently with other established cardiovascular risk factors. Nutritional status and MACE Conclusion CONUT score is a promising marker for long-term outcome prediction and risk stratifications in patients with CAD undergoing PCI. Acknowledgement/Funding None