Influence of undernutrition at admission on clinical outcomes in patients with acute myocardial infarction

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• 作者：Sung Hee Yoo ; RN ; PhD^a ; Hyun Yi Kook ; RN^b ; Young Joon Hong ; MD ; PhD^b ; Ju Han Kim ; MD ; PhD^b ; Youngkeun Ahn ; MD ; PhD^b ; Myung Ho Jeong ; MD ; PhD ; FACC ; FAHA ; FESC ; FSCAI ; FAPSIC^b ; ^{myungho@chollian.net}
• 关键词：Myocardial infarction ; Undernutrition ; Complications ; Mortality
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：March 2017
• 年：2017
• 卷：69
• 期：3
• 页码：555-560
• 全文大小：366 K
• 卷排序：69

文摘

Although the effect of overweight or obesity on clinical outcomes in patients with acute myocardial infarction (MI) has been reported, the effect of undernutrition is not as well understood. Therefore, we investigated whether acute MI patients frequently present with undernutrition, and whether this influences poor clinical outcomes.Methods and resultsUsing the Korea Acute Myocardial Infarction Registry database, we screened initial data on acute MI patients admitted within 48 h of symptom onset to a tertiary university hospital between November 1, 2011 and May 31, 2015. We then assessed nutritional status at admission, using the Geriatric Nutritional Risk Index (GNRI). Of a total of 2251 patients, there were 1585 (70.4%) men, and mean age was 65.0 &plusmn; 12.8 years. Based on GNRI score, undernutrition at admission was present in 409 (18.2%) patients. Multiple logistic regression analysis found undernutrition to be an independent factor influencing post-MI complications [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.61–2.84; p < 0.001], after adjusting for age, sex, hypertension, diabetes, hyperlipidemia, previous stroke, smoking, diagnosis, number of involved vessel lesions, Killip class, atrial fibrillation, baseline blood pressure, hemoglobin, creatine kinase-MB, creatinine, performance of percutaneous coronary intervention, reperfusion time, recanalization, and use of antithrombotics. Undernutrition was also an important factor influencing in-hospital death (OR, 2.48; 95% CI, 1.55–3.95; p < 0.001), after adjusting for all potential factors by univariate analysis.ConclusionsNutritional status is a significant prognostic factor in clinical outcomes after MI during hospitalization. Therefore, nutritional assessment and intervention, especially for undernourished MI patients, should be considered.