Heart and Vessels | 2021
Prognostic impact of malnutrition in elderly patients with acute myocardial infarction
Abstract
We aimed to investigate the prevalence and the prognostic impact of malnutrition using the geriatric nutritional risk index (GNRI) in elderly patients with acute myocardial infarction (AMI). We investigated 130 consecutive patients aged ≥\u200975 years who were discharged following successful primary coronary intervention between March 2009 and December 2016. The mean age of the patients was 81.5\u2009±\u20095.0 years, and 55.4% of them were male. At discharge, the patients’ nutritional statuses were evaluated using the GNRI, which were calculated as follows: 14.89\u2009×\u2009serum albumin (g/dL)\u2009+\u200941.7\u2009×\u2009body mass index/22. The patients were divided into two groups, a low GNRI group (GNRI\u2009<\u200992) with nutrition-related risk and a high GNRI group (GNRI\u2009≥\u200992) without nutrition-related risk. The mean GNRI score of all patients was 95.2\u2009±\u200911.0, and 46 patients (35.4%) had a low GNRI score. During the mean follow-up of 1030\u2009±\u2009850 days, the all-cause mortality was significantly higher in the low GNRI group than in the high GNRI group (32.6% vs. 13.1%, p\u2009<\u20090.001), while the event rates of AMI recurrence and hospitalization due to heart failure did not differ significantly between the two groups. Multivariate Cox proportional analysis revealed that low GNRI was a modest but independent predictor of mortality (hazard ratio, 0.94; 95% confidence interval 0.90–0.98; p\u2009=\u20090.01). Among elderly patients with AMI, malnutrition assessed using the GNRI was often encountered and was an independent predictor of long-term mortality.