Abstract 12288: Negative Impact of Protein-Energy Malnutrition on Long-Term Mortality in the Patients of Acute Decompensated Heart Failure
Background: Protein-energy malnutrition (PEM) is rarely recognized in the setting of acute decompensated heart failure (ADHF). This study was aimed to investigate the impact of PEM on long-term prognosis of ADHF.
Method: National CardiovAScular Center Acute DEcompensated Heart Failure (nCASCADE) database is the single-center registry, prospectively enrolled consecutive 523 patients with ADHF (July 2006-June 2009). We defined patients with serum albumin<3.5g/dl and lymphocyte<1500/mm3 as PEM.
Result: Of 523 patients, 146 (28%) showed PEM who were lower hemoglobin and higher CRP, but age, systolic blood pressure (SBP) on arrival, serum creatinine level, initial BNP level and %fractional shortening were similar as Non-PEM. Kaplan-Meier analysis revealed that the incidence of the combined events of all-cause death or re-hospitalization because of heart failure in long-term follow-up (mean follow-up; 802days) was significantly higher in PEM (Log-rank p<0.001). Moreover, when the patients were divided by PEM as the indicator of whole body condition and by SBP (≥ /< 140mmHg) as the marker of the cardiac function, PEM/Lo-SBP group was higher long-term mortality than other three group (38.3% vs. PEM/Hi-SBP; 29.0%, Non-PEM/Lo-SBP; 30.0% and Non-PEM/Hi-SBP; 15.3%, p<0.001). Multivariate Cox regression analysis showed that PEM/Lo-SBP was the most powerful predictor of combined events. (OR 1.81; 95% CI 1.19 to 2.67)
Conclusion: PEM is substantially observed in patients hospitalized with ADHF and strongly predicts long-term mortality. These findings may indicate that the intervention to the nutrition for the patients of ADHF benefits better prognosis.
- © 2011 by American Heart Association, Inc.