Prognostic Impact of Nutritional Status After Transcatheter Edge-to-Edge Mitral Valve Repair: The MIVNUT Registry
Por:
Caneiro-Queija, B, Raposeiras-Roubin, S, Adamo, M, Freixa, X, Arzamendi, D, Benito-Gonzalez, T, Montefusco, A, Pascual, I, Nombela-Franco, L, Rodes-Cabau, J, Shuvy, M, Portoles-Hernandez, A, Godino, C, Haberman, D, Lupi, L, Regueiro, A, Li, CH, Fernandez-Vazquez, F, Frea, S, Avanzas, P, Tirado-Conte, G, Paradis, JM, Peretz, A, Monivas, V, Baz, JA, Galasso, M, Branca, L, Sanchis, L, Asmarats, L, Garrote-Coloma, C, Angelini, F, Leon, V, de Agustin, JA, Alperi, A, Beeri, R, Maccagni, G, Sabate, M, Fernandez-Peregrina, E, Gualis, J, Bocchino, PP, Curello, S, Iniguez-Romo, A, Estevez-Loureiro, R
Publicada:
18 oct 2022
Resumen:
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/m(2), 72.1% in those with body mass index >= 25 kg/m(2)). 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.
Filiaciones:
Caneiro-Queija, B:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
Raposeiras-Roubin, S:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
Adamo, M:
Spedali Civili Brescia, Cardiac Catheteterizat Lab, Cardiothorac Dept, Brescia, Italy
Freixa, X:
Hosp Clin Barcelona, Barcelona, Spain
Arzamendi, D:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona, Spain
Benito-Gonzalez, T:
Complejo Asistencial Univ Leon, Leon, Spain
Montefusco, A:
Univ Turin, Dept Med Sci, Div Cardiol, Citta & Salute & Sci, Turin, Italy
Pascual, I:
Hosp Univ Cent Asturias, Intervent Cardiol Unit, Oviedo, Spain
Nombela-Franco, L:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid, Spain
Rodes-Cabau, J:
Laval Univ, Quebec Heart & Lung Inst, Cardiol Dept, Quebec City, PQ, Canada
Shuvy, M:
Hadassah Hebrew Univ Med Ctr, Heart Inst, Jerusalem, Israel
Portoles-Hernandez, A:
Hosp Univ Puerta Hierro, Cardiol Dept, Madrid, Spain
Godino, C:
IRCCS San Raffaele Sci Inst, Fac Med, Clin Cardiol Unit, Milan, Italy
Haberman, D:
Kaplan Med Ctr, Rehovot, Israel
Lupi, L:
Spedali Civili Brescia, Cardiac Catheteterizat Lab, Cardiothorac Dept, Brescia, Italy
Regueiro, A:
Hosp Clin Barcelona, Barcelona, Spain
Li, CH:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona, Spain
Fernandez-Vazquez, F:
Complejo Asistencial Univ Leon, Leon, Spain
Frea, S:
Univ Turin, Dept Med Sci, Div Cardiol, Citta & Salute & Sci, Turin, Italy
Avanzas, P:
Hosp Univ Cent Asturias, Intervent Cardiol Unit, Oviedo, Spain
Tirado-Conte, G:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid, Spain
Paradis, JM:
Laval Univ, Quebec Heart & Lung Inst, Cardiol Dept, Quebec City, PQ, Canada
Peretz, A:
Hadassah Hebrew Univ Med Ctr, Heart Inst, Jerusalem, Israel
Monivas, V:
Hosp Univ Puerta Hierro, Cardiol Dept, Madrid, Spain
Baz, JA:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
Galasso, M:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
Branca, L:
Spedali Civili Brescia, Cardiac Catheteterizat Lab, Cardiothorac Dept, Brescia, Italy
Sanchis, L:
Hosp Clin Barcelona, Barcelona, Spain
Asmarats, L:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona, Spain
Garrote-Coloma, C:
Complejo Asistencial Univ Leon, Leon, Spain
Angelini, F:
Univ Turin, Dept Med Sci, Div Cardiol, Citta & Salute & Sci, Turin, Italy
Leon, V:
Hosp Univ Cent Asturias, Intervent Cardiol Unit, Oviedo, Spain
de Agustin, JA:
Hosp Clin San Carlos, Cardiovasc Inst, IdISSC, Madrid, Spain
Alperi, A:
Laval Univ, Quebec Heart & Lung Inst, Cardiol Dept, Quebec City, PQ, Canada
Beeri, R:
Hadassah Hebrew Univ Med Ctr, Heart Inst, Jerusalem, Israel
Maccagni, G:
Spedali Civili Brescia, Cardiac Catheteterizat Lab, Cardiothorac Dept, Brescia, Italy
Sabate, M:
Hosp Clin Barcelona, Barcelona, Spain
Fernandez-Peregrina, E:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona, Spain
Gualis, J:
Complejo Asistencial Univ Leon, Leon, Spain
Bocchino, PP:
Univ Turin, Dept Med Sci, Div Cardiol, Citta & Salute & Sci, Turin, Italy
Curello, S:
Spedali Civili Brescia, Cardiac Catheteterizat Lab, Cardiothorac Dept, Brescia, Italy
Iniguez-Romo, A:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
Estevez-Loureiro, R:
Hosp Alvaro Cunqueiro, Vigo, Spain
Inst Invest Sanitaria Galicia Sur, Vigo, Spain
gold, All Open Access, Gold
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