Malnutrition affects 20% to 60% of hospitalized patients with acute cardiovascular disease, and early nutritional support, preferably enteral, is recommended to improve outcomes.
This AHA scientific statement highlights the high prevalence of malnutrition in acute cardiac inpatients and emphasizes early enteral nutrition to improve clinical outcomes.
Malnutrition can affect patients with various acute cardiovascular disease conditions, including acute coronary syndromes, arrhythmias, or valvular disease; however, most of the literature has focused on patients with heart failure. Malnutrition prevalence estimates range from 20% to 60% for hospitalized patients. Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality. Nutritional support plays a key role for inpatients, particularly in the cardiac intensive care unit, and includes initiation of feeding within 48 hours of hospitalization, preferably through enteral nutrition. Enteral nutrition is more cost-effective compared with parenteral nutrition and can decrease mortality and shorten lengths of stay. Parenteral nutrition is reserved for patients with severe gastrointestinal dysfunction or to supplement nutrition when enteral nutrition is contraindicated, for example, during high pressor doses that preclude adequate intestinal perfusion or when achieving <70% of nutritional targets after the first week. The optimal protein intake for patients with cardiogenic shock is an area of ongoing research, with higher protein approaches not appearing beneficial in recent critical care trials.
Vest et al. (Tue,) conducted a review in Acute cardiac conditions. Nutritional support was evaluated. Malnutrition affects 20% to 60% of hospitalized patients with acute cardiovascular disease, and early nutritional support, preferably enteral, is recommended to improve outcomes.