Abstract 17724: Nutrition Impairment in Patients Hospitalized With Acute Decompensated Heart Failure Relates to Poor Prognosis Even Without Left Ventricular Systolic Dysfunction

Abstract

Background: Although patients with acute decompensated heart failure (ADHF) showing nutrition impairment (NI) have a poor prognosis, it is unclear whether the NI patients without left ventricular systolic dysfunction relate to poor mortality or not.

Method: National CardiovAScular Center Acute DEcompensated Heart Failure (nCASCADE) registry is a prospective observational study of patients hospitalized with ADHF. We defined NI by Nutritional Risk Index (NRI) as follows: NRI = (1.519 × serum albumin, g/dL) + {41.7 × present weight (kg)/ideal body weight (kg)}. Patients were divided into four groups according to NI (NRI ≥ /<47) and % fractional shortening at admission (%FS ≥ /<26): Non-NI/Hi-%FS (n=101), Non-NI/Lo-%FS (n=244), NI/Hi-%FS (n=114), NI/Lo-%FS (n=212).

Result: We studied 671 consecutive patients with ADHF and patients with NI were 48.6%. Kaplan-Meier analysis revealed that the incidence of all-cause death in 3-year follow-up was significantly higher in patients with NI (NI vs. Non-NI; 24.2% vs. 39.9%, log rank test<0.0001) who showed more elderly (74.7 vs. 70.9 years old, p=0.0002), lower body mass index (19.6 vs. 25.6 kg/m², p<0.0001), lower hemoglobin (11.5 vs. 12.4 g/dl, p<0.0001), lower serum albumin (3.5 vs. 3.8g/dl, p=0.0310) but systolic blood pressure, serum creatinine, CRP level at admission were similar as patients without NI. Moreover, multivariate Cox regression analysis showed that NI was one of independent predictors of all-cause death (OR 1.39; 95% CI 1.01 to 1.92) and the incidences of all-cause death in 3-year follow-up were not significantly different by %FS but by NI (Non-NI/Hi-%FS vs. Non-NI/Lo-%FS, NI/Hi-%FS and NI/Lo-%FS; 18.0% vs. 26.6%, 41.0% and 39.1%,respectively) in Figure.

Conclusion: Our data showed that ADHF patients without left ventricular systolic dysfunction but with NI have a poor prognosis in long-term follow-up.