Moderate to severe malnutrition occurred in 33% of STEMI patients with cardiogenic shock and independently predicted over 2.7-fold higher 6-month mortality (HR 2.77).
Does malnutrition increase the risk of all-cause death in patients with cardiogenic shock complicating STEMI?
Moderate to severe malnutrition is present in approximately one-third of patients with cardiogenic shock complicating STEMI and serves as an independent predictor of mortality, particularly within the first 6 months.
Absolute Event Rate: 0% vs 0%
Abstract It is well established that malnutrition is associated with poor clinical outcomes in patients with cardiovascular diseases; however, its application in the context of cardiogenic shock (CS) complicating acute myocardial infarction with ST-segment elevation (STEMI) has not been thoroughly investigated. This study aims to report the prevalence, clinical associations, and prognostic consequences of malnutrition in patients with CS complicating STEMI. We conducted a retrospective population-based cohort study of patients with CS complicating STEMI from June 1, 2015, to May 19, 2024 in the Autonomous Community of Galicia, Spain. CONUT score was used to assess nutritional status. A total of 11,257 patients with STEMI were identified through the Galician Program for the Care of Acute Myocardial Infarction (PROGALIAM, as per its Spanish acronym). From this cohort we selected 1,053 individuals diagnosed with CS, based on the consensus criteria stablished by the Shock Academic Research Consortium (SHARC). From the 1,053 patients with CS complicating STEMI, 219 (20.8 %) were excluded due to missing data for nutritional status. The remained 834 patients were categorized into different malnutrition risk groups according to CONUT score on admission: absent (score 0–1; n=176; 21.1%), mild (score 2–4, n=383; 45.9%), moderate to severe (score 5-12; n=75; 33%). Over a mean followup of 2.2 ± 2.7 years, 457 patients (54.8%) died (337 during hospitalization; 40.4%). Malnutrition was associated with significantly increased risk for all-cause death compared with good nutritional status, (hazard ratio 1.36 95% confidence interval (CI): 1.03-1.78; p=0.029 for mild malnutrition, and 2.18 95% CI: 1.65-2.86; p0.001) for moderate to severe malnutrition, respectively) (Figure 1). These findings are attributable to subacute mortality, which occurs between the 7th day and the sixth month following the event, with no significant increased risk in the first 7 days and after 6 months (Figure 2). After multivariable analyses, moderate to severe malnutrition was an independent predictor of mortality (adjusted HR 2.77 (95% CI 1.15-6.65); p=0.023). Malnutrition in patients with CS complicating STEMI is frequent and is linked to a worse prognosis. Moderate to severe malnutrition occurs in 1 in 3 patients and is an independent predictor of mortality, especially in the first 6 months.Risk for all-cause death Risk for all-cause death by time
Pineiro et al. (Sat,) reported a other. Moderate to severe malnutrition occurred in 33% of STEMI patients with cardiogenic shock and independently predicted over 2.7-fold higher 6-month mortality (HR 2.77).