Prognostic impact of nutritional status in asymptomatic patients with cardiac diseases: a report from the CHART-2...

The prognostic impact of nutritional status is poorly understood in asymptomatic patients with structural and/or functional heart diseases, classified as stage B in the ESC/AHA/ACC chronic heart failure (HF) guidelines.

We evaluated the impact of nutrition, using the controlling nutritional status (CONUT) score, calculated by the serum albumin and total cholesterol levels,and lymphocyte number, in 3,421 stage B patients from the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 Study (mean age: 66.9±12.7 years, male: 71.6%). During a median follow-up of 2.89 years, 224 patients died from cardiovascular (45%, n=102) and noncardiovascular (55%, n=123) causes and 139 experienced hospitalization for HF. Survival at 3 years in patients with CONUT 0-1 (reference, n=2,121), 2 (n=693) and ≥3 (n=607) was 95.5, 92.3, and 73.2%, respectively (P<0.001). The adjusted Cox hazard analyses revealed that the CONUT score was significantly associated with increased incidence of all-cause death (hazard ratio 1.27 per point increase; 95% confidence interval, 1.16-1.39, P<0.001). Subgroup analysis showed that per point increase in the CONUT score was significantly associated with a 17% increase in HF hospitalization in patients ≥70 years old (P=0.049), but not in those aged <70 years.

In the current stage B patients, poor nutritional status was associated with increased incidence of death for the overall population and of HF hospitalization for the elderly proportion.