Prognostic Impact of Nutritional Status After Transcatheter Edge-to-Edge Mitral Valve Repair: The MIVNUT Registry

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 prognost...

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Detalhes bibliográficos
Autores: 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
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2022
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositório:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p13858
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13858
https://ddd.uab.cat/record/277653
Access Level:Acceso aberto
Palavra-chave:CONUT
heart failure
malnutrition
mortality
transcatheter edge-to-edge repair
Descrição
Resumo: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.

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