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Change in Nutritional Status during Hospitalization and Prognosis in Patients with Heart Failure with Preserved Ejection Fraction
Authors:Akihiro Sunaga  Shungo Hikoso  Takahisa Yamada  Yoshio Yasumura  Shunsuke Tamaki  Masamichi Yano  Takaharu Hayashi  Yusuke Nakagawa  Akito Nakagawa  Masahiro Seo  Hiroyuki Kurakami  Tomomi Yamada  Tetsuhisa Kitamura  Taiki Sato  Bolrathanak Oeun  Hirota Kida  Yohei Sotomi  Tomoharu Dohi  Katsuki Okada  Hiroya Mizuno  Daisaku Nakatani  Yasushi Sakata  on behalf of the OCVC-Heart Failure Investigators
Abstract:
The impact of changes in nutritional status during hospitalization on prognosis in patients with heart failure with preserved ejection fraction (HFpEF) remains unknown. We examined the association between changes in the Geriatric Nutritional Risk Index (GNRI) and prognosis during hospitalization in patients with HFpEF stratified by nutritional status on admission. Nutritional status did and did not worsen in 348 and 349 of 697 patients with high GNRI on admission, and in 142 and 143 of 285 patients with low GNRI on admission, respectively. Kaplan–Meier analysis revealed no difference in risk of the composite endpoint, all-cause death, or heart failure admission between patients with high GNRI on admission whose nutritional status did and did not worsen. In contrast, patients with low GNRI on admission whose nutritional status did not worsen had a significantly lower risk of the composite endpoint and all-cause death than those who did. Multivariable analysis revealed that worsening nutritional status was independently associated with a higher risk of the composite endpoint and all-cause mortality in patients with low GNRI on admission. Changes in nutritional status during hospitalization were thus associated with prognosis in patients with malnutrition on admission, but not in patients without malnutrition among those with HFpEF.
Keywords:heart failure with preserved ejection fraction   nutritional status   GNRI   malnutrition
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