Adachi Takeshi, Adachi Shiro, Nakano Yoshihisa, Nishiyama Itsumure, Hirose Miku, Murohara Toyoaki
Department of Cardiology, Nagoya University Hospital Nagoya Japan.
Center for Advanced Medicine and Clinical Research, Department of Advanced Medicine, Nagoya University Hospital Nagoya Japan.
Circ Rep. 2024 Aug 29;6(9):381-388. doi: 10.1253/circrep.CR-24-0023. eCollection 2024 Sep 10.
The prognosis for patients with chronic thromboembolic pulmonary hypertension (CTEPH) using their nutritional status has not been established. We investigated the relationship between the prognosis of patients with CTEPH and the Controlling Nutritional Status (CONUT) score, which is a nutritional assessment tool.
A total of 157 patients with CTEPH was enrolled in the study. The primary outcome was defined as the composite outcome of all-cause mortality and non-elective hospitalization due to heart failure. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff CONUT score for predicting the 1-year rate of the primary outcome. Patients were divided into 2 groups according to the significant cutoff value and compared. Undernutrition was observed in 51.6% of patients. ROC analysis revealed a significant cutoff CONUT score of 3.5 (area under the curve=0.789). The incidence rate of the primary composite outcome was higher in the high CONUT group (score ≥4) than in the low CONUT group (score ≤3; 20% vs. 2.2%; P<0.001). Cox analysis revealed the CONUT score per point increase was an independent risk factor for the primary composite outcomes (hazard ratio 2.301; 95% confidence interval 1.081-4.895; P=0.031).
The CONUT score can predict the 1-year rate of all-cause death and non-elective hospitalization in patients with CTEPH.
利用慢性血栓栓塞性肺动脉高压（CTEPH）患者的营养状况评估其预后的研究尚未开展。我们研究了CTEPH患者的预后与作为营养评估工具的控制营养状况（CONUT）评分之间的关系。
本研究共纳入157例CTEPH患者。主要结局定义为全因死亡率和因心力衰竭非选择性住院的复合结局。采用受试者工作特征（ROC）曲线分析确定预测主要结局1年发生率的临界CONUT评分。根据显著临界值将患者分为两组并进行比较。51.6%的患者存在营养不良。ROC分析显示临界CONUT评分为3.5（曲线下面积=0.789）。CONUT评分高分组（评分≥4）的主要复合结局发生率高于低分组（评分≤3；20%对2.2%；P<0.001）。Cox分析显示CONUT评分每增加1分是主要复合结局的独立危险因素（风险比2.301；95%置信区间1.081-4.895；P=0.031）。
CONUT评分可预测CTEPH患者全因死亡和非选择性住院的1年发生率。
