Elisabetta Tonet1, Gianluca Campo2, Elisa Maietti3, Francesc Formiga4, Manuel Martinez-Sellés5, Rita Pavasini1, Simone Biscaglia1, Matteo Serenelli1, Juan Sanchis6, Pablo Diez-Villanueva7, Giulia Bugani1, Francesco Vitali1, Rossella Ruggiero1, Paolo Cimaglia8, Davide Bernucci1, Stefano Volpato3, Roberto Ferrari9, Albert Ariza-Solé10. 1. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy. 2. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy. Electronic address: cmpglc@unife.it. 3. Department of Medical Science, University of Ferrara, Ferrara, Italy. 4. Internal Medicine, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. 5. Hospital General Universitario Gregorio Maranon, CIBERCV, Universidad Europea, Universidad Complutense, Madrid, Spain. 6. Cardiology Department, Hospital Clínico de Valencia, INCLIVA, Universidad de Valencia, CIBER CV, Valencia, Spain. 7. Hospital Universitario La Princesa, Madrid, Spain. 8. Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy. 9. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy. 10. Cardiology Department, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Abstract
BACKGROUND & AIMS: The present analysis investigated the prevalence and the prognostic implication of nutritional status in older adults hospitalized for acute coronary syndrome (ACS). METHODS: The analysis is based on older ACS patients included in the FRASER and LONGEVO SCA studies. The Global Risk of Acute Coronary Events (GRACE) risk score was computed in all patients. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF, normal for values between 12 and 14, at risk of malnutrition for values between 8 and 11, and malnutrition for values ≤ 7). Physical performance was assessed with the Short Physical Performance Battery (SPPB). Primary outcome was all-cause mortality. RESULTS: The study included 908 patients. Overall, 35 patients (4%) were malnourished and 361 (40%) were at risk of malnutrition. After a median follow-up of 288 [187-370] days, the primary endpoint occurred in 94 (10.5%) patients. The mortality rate was 31% in malnourished subjects, 19% in at-risk patients, 3% in patients with a normal nutritional status (p < 0.001). MNA-SF emerged as an independent predictor of all-cause mortality (HR 0.76, 95%CI 0.68-0.84 for single change unit). The MNA-SF score improved the GRACE score's ability to discriminate subjects at risk of death (ΔC-statistic = 0.076, p < 0.001; ΔBIC -28; IDI 0.052, p < 0.001; NRI 0.793, p < 0.001). The prognostic value of MNA-SF was maintained also by including the SPPB score in the predictive model. CONCLUSION: s: The MNA-SF helped to identify malnutrition in older ACS patients. Moreover, the MNA-SF value is an independent predictor of all-cause mortality and it improves the predictive value of the GRACE risk score.
BACKGROUND & AIMS: The present analysis investigated the prevalence and the prognostic implication of nutritional status in older adults hospitalized for acute coronary syndrome (ACS). METHODS: The analysis is based on older ACS patients included in the FRASER and LONGEVO SCA studies. The Global Risk of Acute Coronary Events (GRACE) risk score was computed in all patients. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF, normal for values between 12 and 14, at risk of malnutrition for values between 8 and 11, and malnutrition for values ≤ 7). Physical performance was assessed with the Short Physical Performance Battery (SPPB). Primary outcome was all-cause mortality. RESULTS: The study included 908 patients. Overall, 35 patients (4%) were malnourished and 361 (40%) were at risk of malnutrition. After a median follow-up of 288 [187-370] days, the primary endpoint occurred in 94 (10.5%) patients. The mortality rate was 31% in malnourished subjects, 19% in at-risk patients, 3% in patients with a normal nutritional status (p < 0.001). MNA-SF emerged as an independent predictor of all-cause mortality (HR 0.76, 95%CI 0.68-0.84 for single change unit). The MNA-SF score improved the GRACE score's ability to discriminate subjects at risk of death (ΔC-statistic = 0.076, p < 0.001; ΔBIC -28; IDI 0.052, p < 0.001; NRI 0.793, p < 0.001). The prognostic value of MNA-SF was maintained also by including the SPPB score in the predictive model. CONCLUSION: s: The MNA-SF helped to identify malnutrition in older ACS patients. Moreover, the MNA-SF value is an independent predictor of all-cause mortality and it improves the predictive value of the GRACE risk score.
Authors: Maria Amasene; María Medrano; Iñaki Echeverria; Miriam Urquiza; Ana Rodriguez-Larrad; Amaia Diez; Idoia Labayen; Besga-Basterra Ariadna Journal: Front Nutr Date: 2022-06-24
Authors: Se Hun Kang; Han Na Song; Jae Youn Moon; Sang-Hoon Kim; Jung-Hoon Sung; In Jai Kim; Sang-Wook Lim; Dong-Hun Cha; Won-Jang Kim Journal: Medicine (Baltimore) Date: 2022-08-26 Impact factor: 1.817
Authors: Elisabetta Tonet; Albert Ariza-Solé; Matteo Serenelli; Francesc Formiga; Juan Sanchis; Rita Pavasini; Pablo Diez-Villanueva; Francesco Vitali; Clara Bonanad; Giovanni Grazzi; Antoni Carol; Giorgio Chiaranda; Graziella Pompei; Laura Sofia Cardelli; Serena Caglioni; Federico Gibiino; Stefano Volpato; Gianluca Campo Journal: BMC Med Date: 2022-01-20 Impact factor: 8.775