Malnutrition in patients with coronary artery disease: Prevalence and mortality in a 46,485 Chinese cohort study |
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| Affiliation: | 1. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People''s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China;2. Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People''s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China;3. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China;4. Department of Cardiology, The First People''s Hospital of Foshan, Guangdong Province, 528000, China;5. Guangdong Provincial People''s Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China;6. Department of Cardiology, Longyan First Hospital Affiliated with Fujian Medical University, Longyan, 364000, China;7. Department of Information Technology, Guangdong Provincial People''s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China;1. Facultad de Ciencias Químicas, Universidad Autónoma de San Luis Potosí, Mexico;2. Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Mexico;1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;2. Department of Kinesiology, University of Georgia, Athens, USA;3. The Nuffield Department of Women''s & Reproductive Health, University of Oxford, Oxford, UK;4. Murdoch Children''s Research Institute, Melbourne, Australia;5. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia;6. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland;7. Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland;1. Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy;2. Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy;3. Istituto di Biofisica, Consiglio Nazionale delle Ricerche, Palermo, Italy;1. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;2. Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece;3. Department of Paediatrics, Medical University Varna, Varna, Bulgaria;4. National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;5. Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria;6. Instituto Investigación Sanitaria Aragón (IISA), CIBERCV, Zaragoza, Spain;7. Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón) CIBERCV, Zaragoza, Spain;8. University of Debrecen, Faculty of Health, Debrecen, Hungary;9. Hungarian Society of Nutrition, 1088 Budapest, Hungary;10. Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 4032 Debrecen, Hungary;11. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Mannerheimintie 166, Helsinki, Finland;12. Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium;13. Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Agro-Health, Heraklion, Greece;1. Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;2. Department of Biostatistics and Medical Record, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;3. NAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;4. Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China;5. Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK;6. Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;7. Institute of Hepatology, Wenzhou Medical University, Wenzhou, China;8. Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China |
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| Abstract: | Background and aimsMalnutrition is associated with poor prognosis in a wide range of illnesses. However, its long-term prognostic impact in general coronary artery disease (CAD) patients is not well known. We aim to report the prevalence and long-term mortality of malnutrition in the whole general population.Methods and resultsIn this retrospective cohort study, the controlling nutritional status (CONUT) score was applied to 46,485 consecutive patients undergoing coronary angiography (CAG) and diagnosed with CAD from January 2007 to July 2018. Patients were stratified as having no malnutrition (n = 19,780), mild (n = 21,092), moderate (n = 5286) and severe malnutrition (n = 327), based on CONUT score. Overall, mean age was 63.1 ± 10.7 years, and 75.8% of patients (n = 35,250) were male. 45.4% of patients were mildly malnourished and 12.1% were moderately or severely malnourished. During a median follow-up of 5.1 years (interquartile range: 3.0–7.7 years), 6093 (17.3%) patients died. After adjusting for confounders, malnutrition risk was associated with significantly increased risk for all-cause death (mild vs. normal, HR = 1.19,95% confidence interval [CI]: 1.12 to 1.28; moderate vs. normal, HR = 1.42,95% CI: 1.30 to 1.55; severe vs. Normal, HR = 1.95, 95% CI: 1.57 to 2.41) (p for trend<0.001). The similar result on all-cause mortality was also found in different subgroups stratified by gender, chronic kidney disease, anemia, percutaneous coronary intervention.ConclusionsMalnutrition is a common complication among patients with CAD, and is strongly associated with increased mortality. Further studies need to explore the efficacy of nutritional interventions on long-term prognosis among CAD patients.This study was registered at Clinicaltrials.gov as NCT04407936. |
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| Keywords: | Malnutrition The controlling nutritional status score Coronary artery disease Prevalence Mortality |
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