Prognostic importance of nutritional status in patients with atrial fibrillation

BACKGROUND: Malnutrition is associated with adverse outcomes in certain cardiovascular diseases. This study investigates the prognostic value of nutritional status in patients with atrial fibrillation (AF). METHODS: This retrospective observational study included 2444 patients with permanent AF admitted between January 2021 and June 2024. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score, and patients were divided into two groups: CONUT < 5 (n = 2194) and 5-12 (n = 250). The association between nutritional status and all-cause mortality was evaluated using Cox regression and Kaplan-Meier analyses. RESULTS: Patients with higher CONUT scores were older (74 ± 12 vs. 70.4 ± 12.6 years, p < 0.001) and had significantly higher mortality (36.4% vs. 11.3%, p < 0.001). Cox regression analysis identified the CONUT score as an independent predictor of mortality (HR 3.56, 95% CI 2.76-4.58, p < 0.001). ROC analysis showed an area under the curve of 0.65 (95% CI 0.62-0.69, p < 0.001), with the CONUT score predicting mortality at a cut-off of 4.5 (sensitivity 67.4%, specificity 78.3%). Kaplan-Meier analysis confirmed a significant survival difference between groups (p < 0.001). CONCLUSIONS: The CONUT score is an independent prognostic factor for all-cause mortality in AF patients and may serve as a simple nutritional screening tool, though its clinical utility requires further validation.