Prognostic significance of the controlling nutritional (CONUT) score in patients with acute coronary syndrome

Abstract

Malnutrition is an independent predictor of adverse outcomes in patients with acute coronary syndrome. The controlling nutritional (CONUT) score has been applied to assess nutritional status, and has been reported to be associated with poor prognosis in patients with heart failure. However, the prognostic impact of the CONUT score in patients with acute coronary syndrome (ACS) remains to be elucidated. We evaluated the CONUT score in 196 patients with ACS who underwent percutaneous coronary intervention. We divided the patients into four groups according to CONUT score (undernutrition degree: normal, CONUT 0–1 (reference); mild, CONUT 2–4; moderate, CONUT 5–8; severe, CONUT 9–12). The endpoint of the present study was composite events including all-cause death, acute coronary syndrome, target vessel revascularization, and stroke. The median CONUT score was significantly higher in patients with composite events than in those without events (P\u2009=\u20090.0058). Kaplan–Meier analysis revealed that a significantly higher event rate in patients with severe malnutrition (log-rank test, P\u2009=\u20090.0222). In the multivariate Cox proportional hazards analysis, CONUT score was independently associated with composite events after adjustment for confounding factors (adjusted hazard ratio 1.284, 95% confidence interval 1.126–1.457, P\u2009=\u20090.0003). Higher CONUT scores were associated with unfavorable outcomes in patients with ACS. Malnutrition assessed by the CONUT score may provide valuable prognostic information in patients with ACS.