Fărcaș Diana Andreea, Cerghizan Anda, Maior Raluca, Mîndrilă Andreea-Cornelia, Tarcea Monica
Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540136 Târgu Mureș, Romania.
Clinic of Internal Medicine II, Emergency Clinical Hospital of Târgu Mureș, 540139 Târgu Mureș, Romania.
Nutrients. 2025 May 20;17(10):1736. doi: 10.3390/nu17101736.
Heart failure (HF) is a major global health burden and a leading cause of morbidity and mortality. Nutritional status has emerged as an essential factor influencing outcomes in HF, with the Controlling Nutritional Status (CONUT) score gaining attention as a simple, objective marker derived from serum albumin, total cholesterol, and lymphocyte count. This meta-analysis evaluated the prognostic value of the CONUT score in predicting all-cause mortality in patients with acute and chronic heart failure. A systematic search was conducted in the PubMed, MEDLINE, Google Scholar, and Cochrane Library databases for the past ten years, using combinations of keywords such as "heart failure", "CONUT score", "malnutrition", and "mortality". Studies were included if they reported hazard ratios (HRs) for all-cause mortality in relation to CONUT score categories in adult HF populations. Eight eligible studies comprising 15,761 patients were included. Pooled analysis showed that higher CONUT scores were significantly associated with increased all-cause mortality (pooled HR = 1.47; 95% CI: 1.30-1.66). Despite substantial heterogeneity ( = 80%), the direction of effect was consistent across studies. The CONUT score is a useful prognostic marker in acute and chronic heart failure patients. Further research should explore the effects of targeted nutritional interventions in high-risk HF patients identified by elevated CONUT scores and efforts to standardize malnutrition cut-offs in clinical practice.
心力衰竭(HF)是一项重大的全球健康负担,也是发病和死亡的主要原因。营养状况已成为影响心力衰竭预后的一个重要因素,控制营养状况(CONUT)评分作为一种从血清白蛋白、总胆固醇和淋巴细胞计数得出的简单、客观的标志物而受到关注。这项荟萃分析评估了CONUT评分在预测急性和慢性心力衰竭患者全因死亡率方面的预后价值。在过去十年中,我们在PubMed、MEDLINE、谷歌学术和考克兰图书馆数据库中进行了系统检索,使用了“心力衰竭”、“CONUT评分”、“营养不良”和“死亡率”等关键词组合。如果研究报告了成年心力衰竭人群中与CONUT评分类别相关的全因死亡率的风险比(HRs),则纳入研究。纳入了八项符合条件的研究,共15761名患者。汇总分析表明,较高的CONUT评分与全因死亡率增加显著相关(汇总HR = 1.47;95% CI:1.30 - 1.66)。尽管存在很大的异质性(I² = 80%),但各研究的效应方向是一致的。CONUT评分是急性和慢性心力衰竭患者有用的预后标志物。进一步的研究应探讨针对CONUT评分升高所识别的高危心力衰竭患者进行营养干预的效果,以及在临床实践中努力规范营养不良的临界值。