控制营养状况评分可预测射血分数保留的心力衰竭患者发生心血管事件的结局。

The controlling nutritional status score predicts outcomes of cardiovascular events in patients with heart failure with preserved ejection fraction.

作者信息

Komorita Takashi, Yamamoto Eiichiro, Sueta Daisuke, Tokitsu Takanori, Fujisue Koichiro, Usuku Hiroki, Nishihara Taiki, Oike Fumi, Takae Masafumi, Egashira Koichi, Takashio Seiji, Ito Miwa, Yamanaga Kenshi, Arima Yuichiro, Sakamoto Kenji, Suzuki Satoru, Kaikita Koichi, Tsujita Kenichi

机构信息

Department of Cardiovascular Medicine and Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

出版信息

Int J Cardiol Heart Vasc. 2020 Jun 26;29:100563. doi: 10.1016/j.ijcha.2020.100563. eCollection 2020 Aug.

BACKGROUNDS

The relationship between cardiovascular outcomes and the Controlling Nutritional Status (CONUT) score in heart failure (HF) with preserved ejection fraction (HFpEF) patients is unknown. This study aimed to evaluate the relationship between the score and cardiovascular outcomes in HFpEF patients.

METHODS AND RESULTS

A total of 506 consecutive HFpEF patients were prospectively observed for up to 1500 days or until the occurrence of cardiovascular events. The mean age was 71.6 ± 9.4 years. Cardiovascular outcomes were compared between the CONUT score 0-1 group with a normal nutritional state (normal group), the CONUT score 2-4 group with a light degree of undernutrition (light group), and the CONUT score 5-8 group with a moderate degree of undernutrition (moderate group). In this study, there were no patients who scored 9-12, which was defined as a severe state of undernutrition. Overall, 238 cardiovascular events were observed during the follow-up period (median: 1159 days). Kaplan-Meier analysis showed that the moderate group was at higher risk of composite cardiovascular events than the normal group < 0.001) and the light group ( = 0.031). The analysis also showed that the light group was at higher risk of composite cardiovascular events than the normal group ( = 0.038). Multivariable Cox proportional hazards analysis with the significant factors from the univariate analysis showed that the CONUT score (hazard ratio: 1.12, 95% confidence interval: 1.03-1.21, 0.005) significantly predicted future cardiovascular events.

CONCLUSION

Nutritional screening using the CONUT score may be useful for predicting cardiovascular events in HFpEF patients.

背景

射血分数保留的心力衰竭（HFpEF）患者的心血管结局与控制营养状况（CONUT）评分之间的关系尚不清楚。本研究旨在评估该评分与HFpEF患者心血管结局之间的关系。

方法与结果

前瞻性观察了连续506例HFpEF患者，观察时间长达1500天或直至发生心血管事件。平均年龄为71.6±9.4岁。比较了营养状态正常的CONUT评分为0 - 1组（正常组）、轻度营养不良的CONUT评分为2 - 4组（轻度组）和中度营养不良的CONUT评分为5 - 8组（中度组）的心血管结局。在本研究中，没有评分为9 - 12的患者，9 - 12分被定义为严重营养不良状态。总体而言，随访期间观察到238例心血管事件（中位数：1159天）。Kaplan - Meier分析显示，中度组发生复合心血管事件的风险高于正常组（<0.001）和轻度组（=0.031）。分析还显示，轻度组发生复合心血管事件的风险高于正常组（=0.038）。对单因素分析中的显著因素进行多变量Cox比例风险分析显示，CONUT评分（风险比：1.12，95%置信区间：1.03 - 1.21，=0.005）显著预测未来心血管事件。