TY - JOUR
T1 - Potential association with malnutrition and allocation of combination medical therapies in hospitalized heart failure patients with reduced ejection fraction
AU - West Tokyo Heart Failure Registry
AU - Kawakubo, Yumiko
AU - Shiraishi, Yasuyuki
AU - Kohsaka, Shun
AU - Kohno, Takashi
AU - Goda, Ayumi
AU - Nagatomo, Yuji
AU - Nishihata, Yosuke
AU - Saji, Mike
AU - Takei, Makoto
AU - Ikegami, Yukinori
AU - Niimi, Nozomi
AU - Sandhu, Alexander Tarlochan Singh
AU - Nakano, Shintaro
AU - Yoshikawa, Tsutomu
AU - Fukuda, Keiichi
AU - Shiraishi, Yasuyuki
AU - Kohsaka, Shun
AU - Kohno, Takashi
AU - Goda, Ayumi
AU - Nishihata, Yosuke
AU - Saji, Mike
AU - Takei, Makoto
AU - Ikegami, Yukinori
AU - Nakano, Shintaro
AU - Yoshikawa, Tsutomu
N1 - Funding Information:
The authors thank the investigators, clinical research coordinators, and institutions involved in the administration of the West Tokyo Heart Failure Registry.
Funding Information:
The West Tokyo Heart Failure Registry was supported by a grant from the Japan Agency for Medical Research and Development [S.K. 201439013C], Grants-in-Aid for Scientific Research [T.Y. 18K08056, 21K08142; T.K. 17K09526, 20K08408; S.K. 20H03915], a Grant-in-Aid for Young Scientists [Y.S. 18K15860], a Grant-in-Aid for Clinical Research from the Japanese Circulation Society [Y.S. 2019], JPSS KAKENHI [T.Y. 23591062, 26461088], and Sakakibara Clinical Research Grant for the Promotion of Science [T.Y. 2012-2020].
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Malnutrition is common in patients with heart failure with reduced ejection fraction (HFrEF) and may influence the long-term prognosis and allocation of combination medical therapy. We reviewed 1231 consecutive patient-level records from a multicenter Japanese registry of hospitalized HFrEF patients. Nutritional status was assessed using geriatric nutritional risk index (GNRI). Combination medical therapy were categorized based on the use of beta-blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists. The composite outcome of all-cause death and HF rehospitalization was assessed. The mean age was 72.0 ± 14.2 years and 42.6% patients were malnourished (GNRI < 92). At discharge, 43.6% and 33.4% of patients were receiving two and three agents, respectively. Malnourished patients had lower rates of combination medical therapy use. The standardized GNRI score was independently associated with the occurrence of adverse events (hazard ratio [HR]: 0.88, 95% confidence interval [CI] 0.79–0.98). Regardless of the GNRI score, referenced to patients receiving single agent, risk of adverse events were lower with those receiving three (HR: 0.70, 95% CI 0.55–0.91) or two agents (HR: 0.70, 95% CI 0.56–0.89). Malnutrition assessed by GNRI score predicts long-term adverse outcomes among hospitalized HFrEF patients. However, its prognosis may be modified with combination medical therapy.
AB - Malnutrition is common in patients with heart failure with reduced ejection fraction (HFrEF) and may influence the long-term prognosis and allocation of combination medical therapy. We reviewed 1231 consecutive patient-level records from a multicenter Japanese registry of hospitalized HFrEF patients. Nutritional status was assessed using geriatric nutritional risk index (GNRI). Combination medical therapy were categorized based on the use of beta-blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists. The composite outcome of all-cause death and HF rehospitalization was assessed. The mean age was 72.0 ± 14.2 years and 42.6% patients were malnourished (GNRI < 92). At discharge, 43.6% and 33.4% of patients were receiving two and three agents, respectively. Malnourished patients had lower rates of combination medical therapy use. The standardized GNRI score was independently associated with the occurrence of adverse events (hazard ratio [HR]: 0.88, 95% confidence interval [CI] 0.79–0.98). Regardless of the GNRI score, referenced to patients receiving single agent, risk of adverse events were lower with those receiving three (HR: 0.70, 95% CI 0.55–0.91) or two agents (HR: 0.70, 95% CI 0.56–0.89). Malnutrition assessed by GNRI score predicts long-term adverse outcomes among hospitalized HFrEF patients. However, its prognosis may be modified with combination medical therapy.
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U2 - 10.1038/s41598-022-12357-4
DO - 10.1038/s41598-022-12357-4
M3 - Article
C2 - 35585128
AN - SCOPUS:85130261305
SN - 2045-2322
VL - 12
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 8318
ER -