Abstract 1549: Micronutrient Deficiency Independently Predicts Event-Free Survival in Patients With Heart Failure
Background. Nutrition is believed to be important in heart failure (HF) management. However, except for sodium, there is little evidence that nutritional intake affects HF outcomes.
Purpose. To determine whether number of dietary micronutrient deficiencies predicted event-free survival after controlling for age, gender, body mass index, dietary sodium, HF etiology, NYHA class, co-morbidities, and ejection fraction.
Methods. A total of 228 patients with HF (age 61±12 years, 66% male, 53% NYHA class III/IIV, EF 34±14%) completed a 4-day food diary to measure intake of sodium and 15 micronutrients. Nutrition Data System software was used to determine intake of sodium, phosphate, calcium, magnesium, niacin, zinc, folate, thiamin, riboflavin, selenium, and vitamins B6, B12, C, D, E and K. Micronutrient deficiencies were defined using formulas from the Institute of Medicine. Patients were followed for 1year to determine time to all cause-hospitalization or death. Hierarchical Cox regression hazard methods were used to determine if number of micronutrient deficiencies predicted event-free survival.
Results. Sixty-seven patients (29%) were hospitalized or died during follow-up. Number of micronutrient deficiencies independently predicted event-free survival (hazard ratio=1.10, 95% CI=1.01–1.19). The risk of an event increased by 10% for each additional micronutrient deficiency. Fig 1⇓ shows event-rates by quartiles of nutrient deficiencies.
Conclusion. Quality of patients’ diet was an independent predictor of event-free survival. These are among the first data to show nutritional intake beyond sodium affects outcomes.
This research has received full or partial funding support from the American Heart Association, Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania & West Virginia).