Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Patients with TCBI ≥ 745 and TCBI < 745
3.2. Nutritional Indexes and Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Casas-Vara, A.; Santolaria, F.; Fernández-Bereciartúa, A.; González-Reimers, E.; García-Ochoa, A.; Martínez-Riera, A. The obesity paradox in elderly patients with heart failure: Analysis of nutritional status. Nutrients 2012, 28, 616–622. [Google Scholar] [CrossRef] [PubMed]
- Takikawa, T.; Sumi, T.; Takahara, K.; Kawamura, Y.; Ohguchi, S.; Oguri, M.; Ishii, H.; Murohara, T. Prognostic Importance of Multiple Nutrition Screening Indexes for 1-Year Mortality in Hospitalized Acute Decompensated Heart Failure Patients. Circ. Rep. 2019, 1, 87–93. [Google Scholar] [CrossRef] [Green Version]
- Kunimura, A.; Ishii, H.; Uetani, T.; Aoki, T.; Harada, K.; Hirayama, K.; Negishi, Y.; Shibata, Y.; Sumi, T.; Kawashima, K.; et al. Impact of Geriatric Nutritional Risk Index on cardiovascular outcomes in patients with stable coronary artery disease. J. Cardiol. 2017, 69, 383–388. [Google Scholar] [CrossRef] [PubMed]
- Wada, H.; Dohi, T.; Miyauchi, K.; Doi, S.; Naito, R.; Konishi, H.; Tsuboi, S.; Ogita, M.; Kasai, T.; Hassan, A.; et al. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention. Am. J. Cardiol. 2017, 119, 1740–1745. [Google Scholar] [CrossRef]
- Narumi, T.; Arimoto, T.; Funayama, A.; Kadowaki, S.; Otaki, Y.; Nishiyama, S.; Takahashi, H.; Shishido, T.; Miyashita, T.; Miyamoto, T.; et al. The prognostic importance of objective nutritional indexes in patients with chronic heart failure. J. Cardiol. 2013, 62, 307–313. [Google Scholar] [CrossRef] [Green Version]
- Sze, S.; Zhang, J.; Pellicori, P.; Morgan, D.; Hoye, A.; Clark, A.L. Prognostic value of simple frailty and malnutrition screening tools in patients with acute heart failure due to left ventricular systolic dysfunction. Clin. Res. Cardiol. 2017, 106, 533–541. [Google Scholar] [CrossRef] [Green Version]
- Doi, S.; Iwata, H.; Wada, H.; Funamizu, T.; Shitara, J.; Endo, H.; Naito, R.; Konishi, H.; Tsuboi, S.; Ogita, M.; et al. A novel and simply calculated nutritional index serves as a useful prognostic indicator in patients with coronary artery disease. Int. J. Cardiol. 2018, 262, 92–98. [Google Scholar] [CrossRef]
- Minami-Takano, A.; Iwata, H.; Miyosawa, K.; Kubota, K.; Kimura, A.; Osawa, S.; Shitara, M.; Okazaki, S.; Suwa, S.; Miyauchi, K.; et al. A Novel Nutritional Index Serves as A Useful Prognostic Indicator in Cardiac Critical Patients Requiring Mechanical Circulatory Support. Nutrients 2019, 11, 1420. [Google Scholar] [CrossRef] [Green Version]
- Lee, G.; Go, S.; Kim, D.-W.; Kim, H.; Kim, J.; An, H.J.; Jang, J.S.; Kim, B.; Hahn, S.; Heo, D.S. Geriatric Nutritional Risk Index as a prognostic marker in patients with extensive-stage disease small cell lung cancer: Results from a randomized controlled trial. Thorac. Cancer 2019, 11, 62–71. [Google Scholar] [CrossRef]
- Yamana, I.; Takeno, S.; Shimaoka, H.; Yamashita, K.; Yamada, T.; Shiwaku, H.; Hashimoto, T.; Yamashita, Y.; Hasegawa, S. Geriatric Nutritional Risk Index as a prognostic factor in patients with esophageal squamous cell carcinoma –retrospective cohort study. Int. J. Surg. 2018, 56, 44–48. [Google Scholar] [CrossRef]
- Hirose, S.; Miyazaki, S.; Yatsu, S.; Sato, A.; Ishiwata, S.; Matsumoto, H.; Shitara, J.; Murata, A.; Kato, T.; Suda, S.; et al. Impact of the Geriatric Nutritional Risk Index on In-Hospital Mortality and Length of Hospitalization in Patients with Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction. J. Clin. Med. 2020, 9, 1169. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sato, N.; Kajimoto, K.; Asai, K.; Mizuno, M.; Minami, Y.; Nagashima, M.; Murai, K.; Muanakata, R.; Yumino, D.; Meguro, T.; et al. Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data. Am. Heart J. 2010, 159, 949–955.e1. [Google Scholar] [CrossRef] [PubMed]
- Sato, N.; Kajimoto, K.; Keida, T.; Mizuno, M.; Minami, Y.; Yumino, D.; Asai, K.; Murai, K.; Muanakata, R.; Aokage, T.; et al. Clinical Features and Outcome in Hospitalized Heart Failure in Japan (From the ATTEND Registry). Circ. J. 2013, 77, 944–951. [Google Scholar] [CrossRef] [Green Version]
- McKee, P.A.; Castelli, W.P.; McNamara, P.M.; Kannel, W.B. The Natural History of Congestive Heart Failure: The Framingham Study. N. Engl. J. Med. 1971, 285, 1441–1446. [Google Scholar] [CrossRef]
- Matsuo, S.; Imai, E.; Horio, M.; Yasuda, Y.; Tomita, K.; Nitta, K.; Yamagata, K.; Tomino, Y.; Yokoyama, H.; Hishida, A. Revised Equations for Estimated GFR From Serum Creatinine in Japan. Am. J. Kidney Dis. 2009, 53, 982–992. [Google Scholar] [CrossRef]
- Bouillanne, O.; Morineau, G.; Dupont, C.; Coulombel, I.; Vincent, J.-P.; Nicolis, I.; Benazeth, S.; Cynober, L.; Aussel, C. Geriatric Nutritional Risk Index: A new index for evaluating at-risk elderly medical patients. Am. J. Clin. Nutr. 2005, 82, 777–783. [Google Scholar] [CrossRef] [Green Version]
- Kenchaiah, S.; Sesso, H.D.; Gaziano, J.M. Response to Letter Regarding Article, “Body Mass Index and Vigorous Physical Activity and the Risk of Heart Failure Among Men”. Circulation 2009, 120. [Google Scholar] [CrossRef] [Green Version]
- Rauchhaus, M.; Clark, A.L.; Doehner, W.; Davos, C.H.; Bolger, A.; Sharma, R.; Coats, A.J.; Anker, S.D. The relationship between cholesterol and survival in patients with chronic heart failure. J. Am. Coll. Cardiol. 2003, 42, 1933–1940. [Google Scholar] [CrossRef]
- Horwich, T.B.; Hernandez, A.F.; Dai, D.; Yancy, C.W.; Fonarow, G.C. Cholesterol levels and in-hospital mortality in patients with acute decompensated heart failure. Am. Heart J. 2008, 156, 1170–1176. [Google Scholar] [CrossRef]
- Zhang, Z.; Pereira, S.L.; Luo, M.; Matheson, E.M. Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2017, 9, 829. [Google Scholar] [CrossRef]
- Kozdag, G.; Ertas, G.; Emre, E.; Akay, Y.; Celikyurt, U.; Sahin, T.; Gorur, G.; Karauzum, K.; Yilmaz, I.; Ural, D.; et al. Low Serum Triglyceride Levels as Predictors of Cardiac Death in Heart Failure Patients. Tex. Heart Inst. J. 2013, 40, 521–528. [Google Scholar]
- Goldwasser, P.; Feldman, J. Association of serum albumin and mortality risk. J. Clin. Epidemiol. 1997, 50, 693–703. [Google Scholar] [CrossRef]
- Horwich, T.B.; Kalantar-Zadeh, K.; MacLellan, R.W.; Fonarow, G.C. Albumin levels predict survival in patients with systolic heart failure. Am. Heart J. 2008, 155, 883–889. [Google Scholar] [CrossRef] [Green Version]
- Uthamalingam, S.; Kandala, J.; Daley, M.; Patvardhan, E.; Capodilupo, R.; Moore, S.A.; Januzzi, J.L. Serum albumin and mortality in acutely decompensated heart failure. Am. Heart J. 2010, 160, 1149–1155. [Google Scholar] [CrossRef]
- Yatsu, S.; Kasai, T.; Matsumoto, H.; Shitara, J.; Shimizu, M.; Murata, A.; Kato, T.; Suda, S.; Hiki, M.; Takagi, A.; et al. Relationship between Hypoalbuminemia on Admission and Long-term Mortality in Patients with Acute Decompensated Heart Failure. Intern. Med. 2019, 58, 1695–1702. [Google Scholar] [CrossRef] [Green Version]
- Nakayama, H.; Koyama, S.; Kuragaichi, T.; Shiba, M.; Fujiwara, H.; Takatsu, Y.; Sato, Y. Prognostic Value of Rising Serum Albumin During Hospitalization in Patients With Acute Heart Failure. Am. J. Cardiol. 2016, 117, 1305–1309. [Google Scholar] [CrossRef]
- Honda, Y.; Nagai, T.; Iwakami, N.; Sugano, Y.; Honda, S.; Okada, A.; Asaumi, Y.; Aiba, T.; Noguchi, T.; Kusano, K.; et al. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥ 65 Years With Acute Heart Failure. Am. J. Cardiol. 2016, 118, 550–555. [Google Scholar] [CrossRef]
- Nishi, I.; Seo, Y.; Hamada-Harimura, Y.; Sato, K.; Sai, S.; Yamamoto, M.; Ishizu, T.; Sugano, A.; Obara, K.; Wu, L.; et al. Nutritional screening based on the controlling nutritional status (CONUT) score at the time of admission is useful for long-term prognostic prediction in patients with heart failure requiring hospitalization. Heart Vessels 2017, 32, 1337–1349. [Google Scholar] [CrossRef] [PubMed]
- Iwakami, N.; Nagai, T.; Furukawa, T.A.; Sugano, Y.; Yasuda, S.; Okada, A.; Asaumi, Y.; Aiba, T.; Noguchi, T.; Kusano, K.; et al. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure. Int. J. Cardiol. 2017, 230, 529–536. [Google Scholar] [CrossRef]
- Cheng, Y.; Sung, S.; Cheng, H.; Hsu, P.; Guo, C.; Yu, W.; Chen, C. Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure. J. Am. Heart Assoc. 2017, 6, e004876. [Google Scholar] [CrossRef]
TCBI < 745 n = 209 | TCBI ≥ 745 n = 208 | p | |
---|---|---|---|
Age, year | 74.2 ± 11.0 | 65.7 ± 14.2 | <0.001 |
Gender (male), n (%) | 123 (58.8) | 147 (70.6) | 0.013 |
BMI, kg/m2 | 21.2 ± 3.7 | 24.6 ± 5.4 | <0.001 |
BW, kg | 52.7 ± 12.4 | 65.8 ± 18.5 | <0.001 |
NYHA class II, (%) | 30 (14.3) | 43 (20.6) | 0.228 |
III, (%) | 76 (36.3) | 68 (32.6) | |
IV, (%) | 103 (49.2) | 97 (46.6) | |
Ischemic heart disease, n (%) | 95 (45.4) | 91 (43.7) | 0.767 |
History of heart failure, n (%) | 108 (56.6) | 105 (50.4) | 0.844 |
AF, n (%) | 94 (44.9) | 91 (34.1) | 0.027 |
Diabetes mellitus, n (%) | 61 (29.1) | 90 (43.2) | 0.003 |
ICD, n (%) | 4 (1.9) | 4 (1.9) | 1.000 |
CRT, n (%) | 1 (0.4) | 1 (0.4) | 1.000 |
Mean BP, mmHg | 95.3 ± 19.1 | 101.1 ± 23.6 | 0.011 |
Systolic BP, mmHg | 136.3 ± 29.4 | 140.8 ± 33.8 | 0.182 |
Diastolic BP, mmHg | 74.7 ± 17.3 | 81.4 ± 21.4 | 0.001 |
HR, rate/min | 93.1 ± 29.4 | 96.7 ± 27.7 | 0.239 |
LVEF, % | 44.3 ± 17.9 | 40.3 ± 16.0 | 0.018 |
Hemoglobin, g/dL | 11.8 ± 2.2 | 13.2 ± 2.4 | <0.001 |
eGFR, mL/min/1.73 m2 | 53.9 ± 27.1 | 53.9 ± 23.3 | 0.991 |
BUN, mg/dL | 26.1 ± 14.7 | 26.2 ± 17.0 | 0.934 |
Sodium, mmol/L | 138.2 ± 4.4 | 139.2 ± 3.8 | 0.010 |
Potassium, mmol/L | 4.2 ± 0.6 | 4.2 ± 0.6 | 0.269 |
TC, mg/dl | 147 ± 31.3 | 191 ± 41.7 | <0.001 |
TG, mg/dl | 64.2 ± 19.8 | 132.2 ± 71.6 | <0.001 |
CRP, mg/dL | 0.9 [3.3] | 0.7 [2.9] | 0.975 |
BNP, pg/mL | 679 [793.4] | 529.2 [698.1] | 0.176 |
Medications at admission | |||
Beta blocker, n (%) | 61 (29.1) | 68 (32.6) | 0.459 |
ACE-Is/ARBs, n (%) | 74 (35.4) | 83 (39.9) | 0.364 |
Aldosterone blocker, n (%) | 35 (16.7) | 19 (9.1) | 0.028 |
Diuretics, n (%) | 87 (41.6) | 62 (29.8) | 0.014 |
Statin, n (%) | 51 (24%) | 38 (18.3%) | 0.951 |
GNRI | 89.5 [17.2] | 94.3 [17.7] | <0.001 |
Univariable | Multivariable | ||||
---|---|---|---|---|---|
HR (95% CI) | p | HR (95% CI) | p | ||
a. All-cause deaths | Age (1 year increase) | 1.05 (1.04–1.07) | <0.001 | 1.02 (1.00–1.04) | 0.031 |
Gender, male | 1.67 (1.11–2.51) | 0.014 | |||
Ischemic heart disease, yes | 1.77 (1.18–2.68) | 0.006 | |||
AF, yes | 1.49 (0.97–2.33) | 0.070 | |||
Mean BP (1 mmHg increase) | 0.99 (0.98–1.00) | 0.017 | |||
Hemoglobin (1 g/dL increase) | 0.73 (0.67–0.80) | <0.001 | 0.86 (0.78–0.95) | 0.004 | |
Na (1 mmol/L increase) | 0.92 (0.88–0.96) | <0.001 | 0.91 (0.87–0.95) | <0.001 | |
eGFR (1 mL/min/1.73 m2 increase) | 0.97 (0.97–0.99) | <0.001 | |||
BUN (1 mg/dL increase) | 1.02 (1.01–1.03) | <0.001 | 1.02 (1.00–1.03) | 0.003 | |
History of HF, yes | 2.30 (1.51–3.61) | <0.001 | |||
Diuretics, yes | 2.48 (1.65–3.74) | <0.001 | 2.3 (1.45–3.72) | <0.001 | |
Log CRP (1 increase) | 1.19 (1.05–1.35) | 0.007 | |||
Log BNP (1 increase) | 1.39 (1.13–1.72) | 0.002 | |||
Log GNRI (1 increase) | 0.03 (0.01–0.15) | <0.001 | |||
Log TCBI (1 increase) | 0.51 (0.38–0.68) | <0.001 | 0.64 (0.44–0.94) | 0.024 | |
b. Cardiovascular deaths | Age (1 year increase) | 1.05 (1.02–1.07) | <0.001 | 1.03 (1.00–1.06) | 0.019 |
Hemoglobin (1 g/dL increase) | 0.73 (0.65–0.81) | <0.001 | 0.82 (0.72–0.93) | 0.002 | |
Sodium (1 mmol/L increase) | 0.93 (0.88–0.99) | 0.034 | 0.93 (0.87–0.99) | 0.026 | |
BUN (1 mg/dL increase) | 1.02 (1.01–1.03) | <0.001 | |||
Diuretics, yes | 3.97 (2.33–6.98) | <0.001 | 3.39 (1.91–6.21) | <0.001 | |
Aldosterone blocker, yes | 2.34 (1.26–4.13) | 0.009 | |||
Beta blocker, yes | 1.79 (1.05–3.00) | 0.032 | |||
Log BNP (1 increase) | 1.64 (1.24–2.19) | <0.001 | |||
Log GNRI (1 increase) | 0.09 (0.01–0.66) | 0.018 | |||
Log TCBI (1 increase) | 0.55 (0.38–0.79) | 0.001 | |||
c. Cancer deaths | Hemoglobin (1 g/dL increase) | 0.71 (0.50–0.96) | 0.028 | ||
LVEF (1 increase) | 1.06 (1.01–1.12) | 0.023 | 1.05 (1.0–1.12) | 0.016 | |
Log GNRI (1 increase) | 0.01 (0.01–0.15) | 0.008 | 0.01 (0.01–0.1) | 0.006 | |
Log TCBI (1 increase) | 0.25 (0.08–0.77) | 0.014 |
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Ishiwata, S.; Yatsu, S.; Kasai, T.; Sato, A.; Matsumoto, H.; Shitara, J.; Shimizu, M.; Murata, A.; Kato, T.; Suda, S.; et al. Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure. Nutrients 2020, 12, 3311. https://doi.org/10.3390/nu12113311
Ishiwata S, Yatsu S, Kasai T, Sato A, Matsumoto H, Shitara J, Shimizu M, Murata A, Kato T, Suda S, et al. Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure. Nutrients. 2020; 12(11):3311. https://doi.org/10.3390/nu12113311
Chicago/Turabian StyleIshiwata, Sayaki, Shoichiro Yatsu, Takatoshi Kasai, Akihiro Sato, Hiroki Matsumoto, Jun Shitara, Megumi Shimizu, Azusa Murata, Takao Kato, Shoko Suda, and et al. 2020. "Prognostic Effect of a Novel Simply Calculated Nutritional Index in Acute Decompensated Heart Failure" Nutrients 12, no. 11: 3311. https://doi.org/10.3390/nu12113311