Nutritional State Predicts All-Cause Death Independent of Comorbidities in Geriatric Patients with Coronary Artery
1Mao Chen, Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu 610041, Sichuan, China. Telephone: 86-189 8060 2046.
Insights
Nutritional risk, assessed by geriatric nutritional risk index (GNRI), independently predicts death in older adults with coronary artery disease (CAD). This highlights the importance of nutritional status in cardiovascular health outcomes.
Area of Science:
- Geriatric cardiology
- Nutritional science
- Public health
Background:
- Older adults with coronary artery disease (CAD) face complex health challenges.
- The impact of nutritional status on adverse outcomes in this population requires further clarification.
- Geriatric nutritional risk index (GNRI) is a tool to assess nutritional status in older individuals.
Purpose of the Study:
- To investigate the association between nutritional risk and mortality in elderly patients with CAD.
- To determine if this association persists independently of clinical status.
- To identify nutritional risk as a potential independent predictor of poor outcomes.
Main Methods:
- A cohort study involving 1772 patients aged over 65 with documented CAD.
- Nutritional risk was evaluated using the geriatric nutritional risk index (GNRI), with risk defined as GNRI < 98.
- All-cause mortality was tracked over a median follow-up of 27 months.
Main Results:
- A total of 224 deaths occurred during the follow-up period.
- Nutritional risk was significantly associated with an increased risk of all-cause death (adjusted hazard ratio 1.99, P=0.001).
- This association remained consistent across various subgroups, irrespective of clinical characteristics.
Conclusions:
- Nutritional status is an independent predictor of all-cause mortality in geriatric patients with CAD.
- The findings underscore the importance of considering nutritional status in managing elderly CAD patients.
- Further research is warranted to explore the efficacy of nutritional support interventions in improving clinical outcomes.
Objective:
To explore whether nutritional risk is associated with poor outcomes independent of complicated clinical status in older patients with coronary artery disease (CAD).
Design:
Cohort study.
Setting:
Patients referred for coronary angiography in West China Hospital, Sichuan University, China.
Participants:
1772 patients with angiographic documented CAD whose age was above 65 years.
Measurements:
Nutritional state was appraised using geriatric nutritional risk index (GNRI). Nutritional risk was defined as the GNRI below 98. The event rate of all-cause death was observed among patients with nutritional risk and those without.
Results:
During a median follow-up period of 27 months, 224 patients died. Multivariate Cox regression analysis showed that nutritional risk was associated with all-cause death (adjusted hazard ratio 1.99; 95% confidence interval 1.35-2.95; P=0.001). Subgroup analysis verified the association between nutritional risk and death among patients with distinct clinical features, comorbidities, and medication. There was no interaction between nutritional risk and clinical characteristics with regard to all-cause death.
Conclusion:
Nutritional state is independently associated with the risk of all-cause death in geriatric patients with CAD. Whether nutritional support in appropriate patients improves clinical outcomes deserves further investigation.
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