Nutritional Status Is Associated with Mortality but Not Appropriate Discharge of Implantable Cardioverter...

Area of Science:

• Cardiology
• Nutritional Science
• Medical Devices

Background:

• Heart failure (HF) is a complex condition often associated with malnutrition.
• Implantable cardioverter defibrillators (ICDs) are used for primary prevention in HF patients.
• The impact of nutritional status on outcomes in HF patients with ICDs requires further investigation.

Purpose of the Study:

• To evaluate the predictive value of nutritional status for mortality in HF patients receiving ICDs.
• To identify factors linked to ICD discharge and overall mortality.
• To compare the efficacy of Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) scores in predicting outcomes.

Main Methods:

• Retrospective analysis of 2017-2021 data from HF patients undergoing primary prevention ICD implantation.
• Follow-up until December 2022, categorizing patients by appropriate ICD shock (ICD-A), no shock (ICD-X), and mortality.
• Nutritional status assessed using PNI and CONUT scores.

Main Results:

• 221 patients included; 20.36% all-cause mortality.
• Low PNI (<47.25) and high CONUT (>2.5) significantly predicted mortality.
• PNI demonstrated a greater predictive accuracy (area under the curve) than CONUT.
• Independent predictors of mortality included low systolic blood pressure, high left-ventricle end-systolic diameter (ESD), low sodium, low total cholesterol, and low PNI.
• Non-ischemic cardiomyopathy and high ESD were associated with appropriate ICD shock.

Conclusions:

• Malnutrition is significantly associated with increased mortality risk in primary prevention ICD recipients.
• The Prognostic Nutritional Index (PNI) is a more effective tool than the CONUT score for assessing mortality risk in this patient population.
• Identifying and addressing malnutrition may improve outcomes for HF patients with ICDs.