Song Yang, Han Su, Zhang Shiru, Yuan Yalun, Wang Meizhu, Sun Zhaoqing
Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Front Nutr. 2025 Jul 8;12:1604470. doi: 10.3389/fnut.2025.1604470. eCollection 2025.
Controlling Nutritional Status (CONUT) score, a novel marker reflecting the malnutrition, has been demonstrated to predict all-cause mortality and major adverse cardiovascular events (MACE) in a wide range of diseases. The research intends to assess the clinical effects of malnutrition on patients who have percutaneous coronary intervention (PCI) after acute myocardial infarction (AMI).
In this retrospective observational study, we consecutively enrolled 3258 patients diagnosed with AMI from 2010 to 2016. Patients were categorized into three groups based on the CONUT score: normal, mild malnutrition, and moderate and severe malnutrition. The primary outcome was all-cause mortality. We develop cox proportional hazards models to investigate the relationship between the CONUT score and all-cause mortality among patients who underwent PCI after AMI.
According to the assessment via the CONUT score, a total of 43.7% patients experienced mild malnutrition, and 4.8% patients experienced moderate and severe malnutrition. During a median follow-up period of 8.6 years, there were 610 patients (18.7%) suffered from all-cause mortality. As malnutrition severity intensified, the occurrence of the primary endpoint saw a steady rise. After adjusting for multiple variables, the group classified with moderate and severe malnutrition exhibited an odds ratio of 1.56 (95% CI 1.13 to 2.15, = 0.007) for the primary endpoint. Incorporating the CONUT score augments the prognostic accuracy of the GRACE risk score in predicting all-cause mortality (Absolute Integrated Discrimination Improvement = 0.008, < 0.001; Category-free Net Reclassification Improvement = 0.144, = 0.001).
Malnutrition is prevalent among patients with AMI and is significantly associated with an increased incidence of all-cause mortality. As a nutritional assessment tool, the CONUT score effectively aids in risk stratification and predicts poor prognosis in patients. Additional prospective clinical trials are required to evaluate the influence of nutritional interventions on outcomes in patients undergoing PCI after AMI.
控制营养状态（CONUT）评分是一种反映营养不良的新型标志物，已被证明可预测多种疾病的全因死亡率和主要不良心血管事件（MACE）。本研究旨在评估营养不良对急性心肌梗死（AMI）后接受经皮冠状动脉介入治疗（PCI）患者的临床影响。
在这项回顾性观察研究中，我们连续纳入了2010年至2016年期间诊断为AMI的3258例患者。根据CONUT评分将患者分为三组：正常、轻度营养不良、中度和重度营养不良。主要结局为全因死亡率。我们建立Cox比例风险模型，以研究CONUT评分与AMI后接受PCI患者的全因死亡率之间的关系。
根据CONUT评分评估，共有43.7%的患者存在轻度营养不良，4.8%的患者存在中度和重度营养不良。在中位随访期8.6年期间，有610例患者（18.7%）死于全因。随着营养不良严重程度的加剧，主要终点事件的发生率稳步上升。在调整多个变量后，中度和重度营养不良组的主要终点事件比值比为1.56（95%CI 1.13至2.15，P = 0.007）。纳入CONUT评分可提高GRACE风险评分预测全因死亡率的预后准确性（绝对综合辨别改善 = 0.008，P < 0.001；无类别净重新分类改善 = 0.144，P = 0.001）。
营养不良在AMI患者中普遍存在，且与全因死亡率的增加显著相关。作为一种营养评估工具，CONUT评分有效地辅助进行风险分层，并预测患者的不良预后。需要进一步的前瞻性临床试验来评估营养干预对AMI后接受PCI患者结局的影响。
