Malnutrition and mortality in patients≥75 years with chronic heart failure

Malnutrition is common in patients with heart failure (HF) but its prognostic impact in advanced age patients remains unsettled. We sought to prospectively assess the impact the Mini Nutritional Assessment-Short Form (MNA-SF), in elderly patients with chronic HF.

We analyzed data from the FRAGIC study a multicentre prospective registry conducted across 16 cardiology departments in Spain that included HF outpatients aged ≥75 years.

From 499 patients (mean age 81.4±4.3 years, 192 [38%] women), 235 had MNA-SF ≤11 (47%). Compared with patients with normal nutritional status, these patients were older (82±7 vs. 81±7, p=0.047), more frequently women (45% vs. 33%, p=0.005), and frail (66% vs. 43%, p=<.001), and showed a more advanced functional class (NYHA≥II 90% vs. 80%, p=0.03) and higher natriuretic peptide levels (NTproBNP>1000pg/ml: 77% vs. 65%, p=0.005). During a median follow-up of 371 days, 58 patients (11.6%) died. One-year mortality was higher in patients with worse nutritional status (39 [17%] vs. 19 [7.2%], p=0.001), which was independently associated with one-year mortality (hazard ratio 1.97, 95% confidence interval 1.09-3.55, p=0.02).

A MNA-SF score≤11 is common in older patients with chronic HF and it is associated with higher mortality at one-year follow-up.