Peng Lei, Tang Jian, Zhang Ningjun, Zhang Zhongnan, Wang Deqi, He Youfu
Department of Cardiology, Linping Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China.
Department of Cardiology, Beijing University of Chinese Medicine East Hospital, Zaozhuang Hospital, Zaozhuang, China.
Front Nutr. 2025 Jan 15;11:1518822. doi: 10.3389/fnut.2024.1518822. eCollection 2024.
Recent studies have reported growing evidence supporting applying the controlling nutritional status (CONUT) score in acute myocardial infarction (AMI) patients. This investigation intended to ascertain the link between CONUT scores and the prognosis in the AMI population.
Multiple electronic databases, encompassing PubMed, Web of Science, Embase, and the Cochrane Library, were retrieved from the inception of the databases until July 20, 2024, to explore the link between CONUT scores and adverse clinical outcomes in individuals with AMI. Primary outcomes consisted of major adverse cardiovascular events (MACE) and mortality, while secondary outcomes encompassed stroke, cardiac death, myocardial reinfarction, revascularization, ventricular arrhythmias, and atrioventricular block. A random-effects meta-analysis was executed, with CONUT scores treated as either categorical or continuous variables. Sensitivity analyses and Egger's test were conducted to appraise the robustness of results and publication bias, respectively. Subgroup analyses were executed to account for various confounding factors. Moreover, the GRADE system was leveraged to appraise the quality of evidence for all outcomes.
Fifteen studies were included in our analysis. The statistical analyses on both categorical and continuous variables unraveled that a high CONUT score was markedly linked to an elevated risk of MACE [categorical variable: odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.42-2.15; continuous variable: standardized mean difference (SMD) = 1.02, 95% CI = 0.78-1.26], mortality (categorical variable: OR = 2.08, 95% CI = 1.70-2.55; continuous variable: SMD = 1.16, 95% CI = 0.57-1.74), cardiac death (categorical variable: OR = 2.81, 95% CI = 1.67-4.73), myocardial reinfarction (categorical variable: OR = 2.21, 95% CI = 1.28-3.83), and atrioventricular block (categorical variable: OR = 5.21, 95% CI = 1.83-14.89) in AMI patients. However, no significant association was found between a high CONUT score and stroke (categorical variable: OR = 1.52, 95% CI = 0.98-2.35), revascularization (categorical variable: OR = 2.92, 95% CI = 0.58-14.79), and ventricular arrhythmias (categorical variable: OR = 2.57, 95% CI = 0.06-107.21).
The CONUT score may serve as a promising and cost-effective prognostic biomarker for individuals with AMI.
PROSPERO: CRD42024574048.
最近的研究报告了越来越多的证据支持在急性心肌梗死（AMI）患者中应用控制营养状况（CONUT）评分。本研究旨在确定CONUT评分与AMI人群预后之间的联系。
检索多个电子数据库，包括PubMed、Web of Science、Embase和Cochrane图书馆，检索时间从数据库建立至2024年7月20日，以探索CONUT评分与AMI患者不良临床结局之间的联系。主要结局包括主要不良心血管事件（MACE）和死亡率，次要结局包括中风、心源性死亡、心肌再梗死、血管重建、室性心律失常和房室传导阻滞。进行随机效应荟萃分析，将CONUT评分视为分类变量或连续变量。分别进行敏感性分析和Egger检验以评估结果的稳健性和发表偏倚。进行亚组分析以考虑各种混杂因素。此外，利用GRADE系统评估所有结局的证据质量。
我们的分析纳入了15项研究。对分类变量和连续变量的统计分析均表明，高CONUT评分与AMI患者发生MACE的风险升高显著相关[分类变量：比值比（OR）=1.75，95%置信区间（CI）=1.42-2.15；连续变量：标准化均值差（SMD）=1.02，95%CI=0.78-1.26]、死亡率（分类变量：OR=2.08，95%CI=1.70-2.55；连续变量：SMD=1.16，95%CI=0.57-1.74）、心源性死亡（分类变量：OR=2.81，95%CI=1.67-4.73）、心肌再梗死（分类变量：OR=2.21，95%CI=1.28-3.83）和房室传导阻滞（分类变量：OR=5.21，95%CI=1.83-14.89）。然而，未发现高CONUT评分与中风（分类变量：OR=1.52，95%CI=0.98-2.35）、血管重建（分类变量：OR=2.92，95%CI=0.58-14.79）和室性心律失常（分类变量：OR=2.57，95%CI=0.06-107.21）之间存在显著关联。
CONUT评分可能是AMI患者一种有前景且具有成本效益的预后生物标志物。
PROSPERO：CRD42024574048。
