Post-discharge changes in nutritional status predict prognosis in patients with acute decompensated HFpEF from the PURSUIT-HFpEF Registry

• Published in: Heart and vessels 2024-12
• Main Authors: Kitao, Takashi, Hikoso, Shungo, Tamaki, Shunsuke, Seo, Masahiro, Yano, Masamichi, Hayashi, Takaharu, Nakagawa, Akito, Nakagawa, Yusuke, Sotomi, Yohei, Nakatani, Daisaku, Yamada, Takahisa, Yasumura, Yoshio, Sakata, Yasushi
• Format: Article
• Language: English
• ISSN: 1615-2573; 1615-2573
• DOI: 10.1007/s00380-024-02499-y

Undernutrition has been identified as a poor prognostic factor in heart failure with preserved ejection fraction (HFpEF). This study aimed to evaluate the impact of changes in nutritional status from discharge to one year post-discharge on the prognosis of patients with HFpEF. Initially, 547 HFpEF cases were classified into a normal nutrition group (NN) (n = 130) and an undernutrition group (UN) (n = 417), according to Controlling Nutritional Status (CONUT) scores at discharge. These groups were further subdivided according to CONUT scores one year post-discharge into NN (G1, n = 88) and UN (G2, n = 42), and NN (G3, n = 147) and UN (G4, n = 270), respectively. The primary end point was defined as a composite of all-cause mortality or heart failure readmission after the visit one year post-discharge. Normal nutrition was defined as a CONUT score of 0 or 1, and undernutrition as a CONUT score of ≥ 2. We compared the incidence rates of the primary end point between G1 and G2, and G3 and G4, and identified predictors for abnormalization or normalization of CONUT score one year post-discharge, as well as covarying factors with change in CONUT. In a multivariable Cox proportional hazards model, abnormalization of CONUT score was associated with an increased risk of the primary end point (adjusted HR [hazard ratio]: 2.87, 95% CI [confidence interval]: 1.32-6.22, p = 0.008), while normalization of CONUT was associated with a reduced risk (adjusted HR: 0.40, 95% CI: 0.23-0.67, p