TY - JOUR
T1 - Prognostic Impact of Nutritional Status After Transcatheter Edge-to-Edge Mitral Valve Repair
T2 - The MIVNUT Registry
AU - Caneiro-Queija, Berenice
AU - Raposeiras-Roubin, Sergio
AU - Adamo, Marianna
AU - Freixa, Xavier
AU - Arzamendi, Dabit
AU - Benito-González, Tomas
AU - Montefusco, Antonio
AU - Pascual, Isaac
AU - Nombela-Franco, Luis
AU - Rodes-Cabau, Josep
AU - Shuvy, Mony
AU - Portolés-Hernández, Antonio
AU - Godino, Cosmo
AU - Haberman, Dan
AU - Lupi, Laura
AU - Regueiro, Ander
AU - Li, Chin Hion
AU - Fernández-Vázquez, Felipe
AU - Frea, Simone
AU - Avanzas, Pablo
AU - Tirado-Conte, Gabriela
AU - Paradis, Jean Michel
AU - Peretz, Alona
AU - Moñivas, Vanessa
AU - Baz, Jose A.
AU - Galasso, Michele
AU - Branca, Luca
AU - Sanchís, Laura
AU - Asmarats, Lluís
AU - Garrote-Coloma, Carmen
AU - Angelini, Filippo
AU - León, Victor
AU - de Agustín, José A.
AU - Alperi, Alberto
AU - Beeri, Ronen
AU - Maccagni, Gloria
AU - Sabaté, Manel
AU - Fernández-Peregrina, Estefanía
AU - Gualis, Javier
AU - Bocchino, Pier Paolo
AU - Curello, Salvatore
AU - Íñiguez-Romo, Andrés
AU - Estévez-Loureiro, Rodrigo
N1 - Publisher Copyright: © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/10/18
Y1 - 2022/10/18
N2 - BACKGROUND: Malnutrition is associated with poor prognosis in several cardiovascular diseases. However, its prognostic impact in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) is not well known. This study sought to assess the prevalence, clinical associations, and prognostic consequences of malnutrition in patients undergoing TEER. METHODS AND RESULTS: A total of 892 patients undergoing TEER from the international MIVNUT (Mitral Valve Repair and Nutritional Status) registry were studied. Malnutrition status was assessed with the Controlling Nutritional Status score. The association of nutritional status with mortality was analyzed with multivariable Cox regression models, whereas the association with heart failure admission was assessed by Fine-Gray models, with death as a competing risk. According to the Controlling Nutritional Status score, 74.4% of patients with TEER had any degree of malnutrition at the time of TEER (75.1% in patients with body mass index <25 kg/m2, 72.1% in those with body mass index ≥25 kg/m2). However, only 20% had moderate–severe malnutrition. TEER was successful in most of patients (94.2%). During a median follow-up of 1.6 years (interquartile range, 0.6–3.0), 267 (29.9%) patients died and 256 patients (28.7%) were admitted for heart failure after TEER. Compared with normal nutritional status moderate–severe malnutrition resulted a strong predictor of mortality (adjusted hazard ratio [HR], 2.1 [95% CI, 1.1–2.4]; P<0.001) and heart failure admission (adjusted subdistribution HR, 1.6 [95% CI, 1.1–2.4]; P=0.015). CONCLUSIONS: Malnutrition is common among patients submitted to TEER, and moderate–severe malnutrition is strongly associated with increased mortality and heart failure readmission. Assessment of nutritional status in these patients may help to improve risk stratification.
AB - BACKGROUND: Malnutrition is associated with poor prognosis in several cardiovascular diseases. However, its prognostic impact in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) is not well known. This study sought to assess the prevalence, clinical associations, and prognostic consequences of malnutrition in patients undergoing TEER. METHODS AND RESULTS: A total of 892 patients undergoing TEER from the international MIVNUT (Mitral Valve Repair and Nutritional Status) registry were studied. Malnutrition status was assessed with the Controlling Nutritional Status score. The association of nutritional status with mortality was analyzed with multivariable Cox regression models, whereas the association with heart failure admission was assessed by Fine-Gray models, with death as a competing risk. According to the Controlling Nutritional Status score, 74.4% of patients with TEER had any degree of malnutrition at the time of TEER (75.1% in patients with body mass index <25 kg/m2, 72.1% in those with body mass index ≥25 kg/m2). However, only 20% had moderate–severe malnutrition. TEER was successful in most of patients (94.2%). During a median follow-up of 1.6 years (interquartile range, 0.6–3.0), 267 (29.9%) patients died and 256 patients (28.7%) were admitted for heart failure after TEER. Compared with normal nutritional status moderate–severe malnutrition resulted a strong predictor of mortality (adjusted hazard ratio [HR], 2.1 [95% CI, 1.1–2.4]; P<0.001) and heart failure admission (adjusted subdistribution HR, 1.6 [95% CI, 1.1–2.4]; P=0.015). CONCLUSIONS: Malnutrition is common among patients submitted to TEER, and moderate–severe malnutrition is strongly associated with increased mortality and heart failure readmission. Assessment of nutritional status in these patients may help to improve risk stratification.
KW - CONUT
KW - heart failure
KW - malnutrition
KW - mortality
KW - transcatheter edge-to-edge repair
UR - http://www.scopus.com/inward/record.url?scp=85140016112&partnerID=8YFLogxK
U2 - https://doi.org/10.1161/JAHA.121.023121
DO - https://doi.org/10.1161/JAHA.121.023121
M3 - مقالة
C2 - 36216434
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 20
M1 - e023121
ER -
