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RESEARCH PRODUCT

Nutritional status and all-cause mortality in older adults with acute coronary syndrome.

Giulia BuganiManuel Martínez-sellésRoberto FerrariRita PavasiniRossella RuggieroAlbert Ariza-soléDavide BernucciJuan SanchisElisabetta TonetSimone BiscagliaStefano VolpatoFrancesc FormigaFrancesco VitaliPaolo CimagliaPablo Díez-villanuevaElisa MaiettiMatteo SerenelliGianluca Campo

subject

0301 basic medicineAcute coronary syndromemedicine.medical_specialtyAncianoEnfermedad cardiovascularShort Physical Performance BatteryNutritional Status030209 endocrinology & metabolismCritical Care and Intensive Care MedicineNO03 medical and health sciences0302 clinical medicineElderlyInternal medicineCause of DeathEnfermos cardíacosmedicineClinical endpointHumansAcute Coronary SyndromeMortalityNutritionAgedAcute coronary syndrome; Elderly; Mortality; NutritionAged 80 and over030109 nutrition & dieteticsNutrition and DieteticsFramingham Risk Scorebusiness.industryMortality rateMalnutritionNutritional statusmedicine.diseaseMalnutritionNutriciónAcute coronary syndromebusinessAncianosAll cause mortality

description

Background & aims The present analysis investigated the prevalence and the prognostic implication of nutritional status in older adults hospitalized for acute coronary syndrome (ACS). Methods The analysis is based on older ACS patients included in the FRASER and LONGEVO SCA studies. The Global Risk of Acute Coronary Events (GRACE) risk score was computed in all patients. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF, normal for values between 12 and 14, at risk of malnutrition for values between 8 and 11, and malnutrition for values ≤ 7). Physical performance was assessed with the Short Physical Performance Battery (SPPB). Primary outcome was all-cause mortality. Results The study included 908 patients. Overall, 35 patients (4%) were malnourished and 361 (40%) were at risk of malnutrition. After a median follow-up of 288 [187–370] days, the primary endpoint occurred in 94 (10.5%) patients. The mortality rate was 31% in malnourished subjects, 19% in at-risk patients, 3% in patients with a normal nutritional status (p < 0.001). MNA-SF emerged as an independent predictor of all-cause mortality (HR 0.76, 95%CI 0.68–0.84 for single change unit). The MNA-SF score improved the GRACE score's ability to discriminate subjects at risk of death (ΔC-statistic = 0.076, p < 0.001; ΔBIC -28; IDI 0.052, p < 0.001; NRI 0.793, p < 0.001). The prognostic value of MNA-SF was maintained also by including the SPPB score in the predictive model. Conclusion s: The MNA-SF helped to identify malnutrition in older ACS patients. Moreover, the MNA-SF value is an independent predictor of all-cause mortality and it improves the predictive value of the GRACE risk score. Sin financiación 7.325 JCR (2020) Q1, 7/88 Nutrition & Dietetics 1.915 SJR (2020) Q1, 8/88 Critical Care and Intensive Care Medicine No data IDR 2020 UEM

yearjournalcountryeditionlanguage
2020-01-01Clinical nutrition (Edinburgh, Scotland)
10.1016/j.clnu.2019.06.025https://pubmed.ncbi.nlm.nih.gov/31542244