Söner Serdar, Güzel Tuncay, Aktan Adem, Kılıç Raif, Arslan Bayram, Demir Muhammed, Güzel Hamdullah, Taştan Ercan, Okşul Metin, Cömert Adnan Duha, Ertaş Faruk
Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, 21070, Diyarbakır, Turkey.
Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, 21070, Diyarbakır, Turkey.
Nutr Metab Cardiovasc Dis. 2025 Mar;35(3):103794. doi: 10.1016/j.numecd.2024.103794. Epub 2024 Nov 20.
Many scoring systems are used to evaluate malnutrition, but there is no consensus on which scoring system would be more appropriate. We aimed to investigate the effect of malnutrition in patients with non-valvular atrial fibrillation (NVAF) and to compare three scoring systems.
A total of 2592 patients with non-valvular AF from 35 different centers in Turkey were included in this prospective study. All participants were divided into two groups: 761 patients who died and 1831 patients who were alive. The malnutrition status of all participants was evaluated with three scoring systems. The primary outcome was all-cause mortality. The mean age of the population was 68.7 ± 11.1 years, and 55.5 % were female. According to Cox regression analysis, the geriatric nutritional risk index (GNRI) (HR = 0.989, 95 % CI: 0.982-0.997, p = 0.007), controlling nutritional status (CONUT) score (HR = 1.121, 95 % CI: 1.060-1.185, p < 0.001), and prognostic nutritional index (PNI) (HR = 0.980, 95 % CI: 0.962-0.999, p = 0.036) were found to be significant mortality predictors. ROC curve analysis indicated GNRI (AUC = 0.568), CONUT (AUC = 0.572), and PNI (AUC = 0.547) had moderate predictive values. Kaplan-Meier analysis showed that increasing the risk class based on GNRI (p < 0.001) and CONUT (p < 0.001) was associated with decreased survival, while PNI staging had no statistically significant effect (p = 0.266).
Malnutrition, determined by three scoring systems, was found to be an independent predictor of all-cause mortality in NVAF patients. Nutritional examination may provide useful information for prognosis and risk stratification in patients with NVAF.
许多评分系统用于评估营养不良，但对于哪种评分系统更为合适尚无共识。我们旨在研究营养不良对非瓣膜性心房颤动（NVAF）患者的影响，并比较三种评分系统。
这项前瞻性研究纳入了来自土耳其35个不同中心的总共2592例非瓣膜性房颤患者。所有参与者被分为两组：761例死亡患者和1831例存活患者。使用三种评分系统评估所有参与者的营养不良状况。主要结局是全因死亡率。研究人群的平均年龄为68.7±11.1岁，女性占55.5%。根据Cox回归分析，老年营养风险指数（GNRI）（HR = 0.989，95%CI：0.982 - 0.997，p = 0.007）、控制营养状况（CONUT）评分（HR = 1.121，95%CI：1.060 - 1.185，p < 0.001）和预后营养指数（PNI）（HR = 0.980，95%CI：0.962 - 0.999，p = 0.036）被发现是显著的死亡率预测因素。ROC曲线分析表明，GNRI（AUC = 0.568）、CONUT（AUC = 0.572）和PNI（AUC = 0.547）具有中等预测价值。Kaplan - Meier分析显示，基于GNRI（p < 0.001）和CONUT（p < 0.001）增加风险等级与生存率降低相关，而PNI分期无统计学显著影响（p = 0.266）。
通过三种评分系统确定的营养不良被发现是NVAF患者全因死亡率的独立预测因素。营养检查可能为NVAF患者的预后和风险分层提供有用信息。
