Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction

Klara Komici, Dino Franco Vitale, Angela Mancini, Leonardo Bencivenga, Maddalena Conte, Sandra Provenzano, Fabrizio Vincenzo Grieco, Lucia Visaggi, Ilaria Ronga, Antonio Cittadini, Graziamaria Corbi, Bruno Trimarco, Carmine Morisco, Dario Leosco, Nicola Ferrara, Giuseppe Rengo

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Abstract

BACKGROUND: Malnutrition is a frequent condition in the elderly, and is associated with prolonged hospitalization and increased mortality. However, the impacts of malnutrition among elderly patients with acute myocardial infarction have not been clarified yet.

METHODS AND RESULTS: We enrolled 174 patients aged 65 years and over, admitted with the diagnosis of acute myocardial infarction (AMI), who underwent evaluation of nutritional status by Mini Nutritional Assessment (MNA) and evaluation of mortality risk by GRACE Score 2.0. All-cause mortality was the outcome considered for this study. Over a mean follow-up of 24.5 ± 18.2 months, 43 deaths have been registered (24.3%). Non-survivors were more likely to be older, with worse glomerular filtration rate, lower systolic blood pressure, lower albumin and MNA score, higher prevalence of Killip classification III-IV grade, and higher Troponin I levels. Multivariate Cox proportional analysis revealed that GRACE Score and MNA showed a significant and independent impact on mortality, (HR = 1.76, 95%, CI = 1.34⁻2.32, and HR = 0.56, 95% CI = 0.42⁻0.73, respectively). Moreover, the clinical decision curve revealed a higher clinical net benefit when the MNA was included, compared to the partial models without MNA.

CONCLUSION: Nutritional status is an independent predictor of long-term mortality among elderly patients with AMI. MNA score in elderly patients with AMI may help prognostic stratification and identification of patients with, or at risk of, malnutrition in order to apply interventions to improve nutritional status, and maybe survival in this population.

Original languageEnglish
JournalNutrients
Volume11
Issue number2
DOIs
Publication statusPublished - Jan 22 2019

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Keywords

  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Malnutrition/complications
  • Myocardial Infarction/mortality
  • Nutrition Assessment
  • Nutritional Status
  • Risk Factors

Cite this

Komici, K., Vitale, D. F., Mancini, A., Bencivenga, L., Conte, M., Provenzano, S., Grieco, F. V., Visaggi, L., Ronga, I., Cittadini, A., Corbi, G., Trimarco, B., Morisco, C., Leosco, D., Ferrara, N., & Rengo, G. (2019). Impact of Malnutrition on Long-Term Mortality in Elderly Patients with Acute Myocardial Infarction. Nutrients, 11(2). https://doi.org/10.3390/nu11020224