Abstract Background As a common comorbidity in cardiovascular patients, anemia is associated with a poor clinical status and worse outcomes in those with acute myocardial infarction (AMI).Likewise, malnutrition is known to negatively impact prognosis across various diseases. However, the prevalence and prognostic significance of malnutrition in patients with AMI who also have chronic anemia remain underexplored. Purpose This study sought to report the prevalence, clinical associations, and prognostic consequences of malnutrition in AMI patients with chronic anemia. Methods This study included 23,162 AMI patients with chronic anemia from 82 secondary or tertiary hospitals between January 1, 2010 and March 31, 2024. Chronic anemia was defined as a hemoglobin (Hb) level of less than 135g/L in men and less than 120g/L in women. The NRI calculation formula is as follows: 1.489 × serum albumin (g/L) + 41.7 × (weight in kilograms/ideal weight). Based on the NRI score, patients were divided into two groups: good nutritional status (NRI ≥ 100) and malnutrition status (NRI 100). Cox multivariable regression analysis was used to assess the relationships between malnutrition risk and 1-year outcomes, including all-cause death and major adverse cardiac or cerebral events (MACCE, defined as cardiovascular mortality, reinfarction, or ischemic stroke). Propensity score matching (PSM) was used to adjust for confounding factors. Survival was plotted with the Kaplan–Meier curve. Results Based on the classification by the NRI, 13,625 (58.8%) patients in good nutritional status, while 9,537 (41.2%) patients had malnutrition. In contrast to good nutritional group, the malnutrition group had a higher average age and a greater burden of comorbidities. During 1-year follow-up, the incidence of adverse events was higher in malnutrition group compared to good nutritional group (all-cause death: 22.4% vs. 9.7%, P0.001, MACCE: 24.7% vs. 15.0%, P0.001). Compared with good nutritional status, malnutrition was associated with significantly increased risk for all-cause death (aHR:1.304, 95%CI:1.215-1.400, P 0.001) and MACCE (aHR:1.149, 95%CI:1.080-1.222, P 0.001). These findings remained consistent in the 1:1 PSM cohort (n = 16,414), with all-cause death (aHR:1.310, 95%CI:1.210-1.419, P 0.001) and MACCE (aHR:1.145, 95%CI:1.067-1.228, P 0.001). Kaplan-Meier curve analysis also revealed a significant reduction in the incidence of all-cause death and MACCE in the good nutritional group. Conclusion Malnutrition is common among AMI patients with chronic anemia, and is strongly associated with increased mortality and cardiovascular events. Clinical trials are needed to prospectively evaluate the efficacy of nutritional interventions on outcomes in those patients.Kaplan-Meier curves for primary outcomes Cox analysis of primary outcomes.
Guo et al. (Sat,) studied this question.