Ishibashi Shun, Sakakura Kenichi, Ikeda Tomoya, Taniguchi Yousuke, Jinnouchi Hiroyuki, Tsukui Takunori, Watanabe Yusuke, Hatori Masashi, Yamamoto Kei, Seguchi Masaru, Fujita Hideo
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City 330-8503, Japan.
J Clin Med. 2023 Sep 22;12(19):6134. doi: 10.3390/jcm12196134.
Recently, the nutritional status of patients has drawn attention in an aging society. Early studies have reported that nutritional status is related to long-term outcomes in patients with acute myocardial infarction (AMI). However, it is not necessarily simple to evaluate the nutritional status of patients with AMI. We hypothesized that appetite before discharge can be a predictor for long-term adverse cardiovascular events in patients with AMI. This retrospective study aimed to investigate whether appetite is related to long-term adverse outcomes in patients with AMI.
This study included 1006 patients with AMI, and divided them into the good appetite group ( = 860) and the poor appetite group ( = 146) according to the percentage of the dietary intake on the day before discharge. Major adverse cardiac events (MACE), which were defined as a composite of all-cause death, non-fatal MI, and re-admission for heart failure, were set as the primary outcome.
The median follow-up duration was 996 days, and a total of 243 MACE was observed during the study period. MACE was more frequently observed in the poor appetite group than in the good appetite group (42.5% versus 21.0%, < 0.001). In the multivariate COX hazard model, poor appetite was significantly associated with MACE (Hazard ratio 1.698, 95% confidence interval 1.243-2.319, < 0.001) after controlling for multiple confounding factors.
Appetite at the time of discharge was significantly associated with long-term clinical outcomes in patients with AMI. Patients with poor appetite should be carefully followed up after discharge from AMI.
近年来，在老龄化社会中，患者的营养状况受到了关注。早期研究报告称，营养状况与急性心肌梗死（AMI）患者的长期预后相关。然而，评估AMI患者的营养状况并非易事。我们假设出院前的食欲可作为AMI患者长期不良心血管事件的预测指标。这项回顾性研究旨在调查食欲是否与AMI患者的长期不良预后相关。
本研究纳入了1006例AMI患者，并根据出院前一天的饮食摄入量百分比将他们分为食欲良好组（n = 860）和食欲不佳组（n = 146）。将主要不良心脏事件（MACE）设定为主要结局，MACE定义为全因死亡、非致命性心肌梗死和因心力衰竭再次入院的综合指标。
中位随访时间为996天，研究期间共观察到243例MACE。食欲不佳组的MACE发生率高于食欲良好组（42.5%对21.0%，P < 0.001）。在多变量COX风险模型中，在控制了多个混杂因素后，食欲不佳与MACE显著相关（风险比1.698，95%置信区间1.243 - 2.319，P < 0.001）。
AMI患者出院时的食欲与长期临床结局显著相关。AMI出院后，食欲不佳的患者应进行密切随访。
