Key result
Changing from nutritional risk to non-nutritional risk after TAVR was associated with a reduced risk of the composite of death and heart failure hospitalization (HR 0.44; 95% CI 0.32-0.62; P<0.001).
Why the study?
Limited data are available regarding change in nutritional status after transcatheter aortic valve replacement (TAVR).
Does improvement in nutritional risk status after TAVR reduce mortality and heart failure hospitalization in TAVR patients?
Observational (n=433)
Does improvement in nutritional risk status after TAVR reduce mortality and heart failure hospitalization in TAVR patients?
Hazard Ratio: 0.44 (95% CI 0.32–0.62)
p-value: p=<0.001
Improvement in nutritional status after TAVR is associated with a significantly lower risk of mortality and heart failure hospitalization, highlighting the prognostic importance of nutritional risk.
Monitoring nutritional status after TAVR may aid risk stratification; leaves open whether interventions targeting nutrition reduce events.
Background: Limited data are available regarding change in the nutritional status after transcatheter aortic valve replacement (TAVR). This study evaluated the prognostic impact of the change in the geriatric nutritional risk index following TAVR. Methods: TAVR patients were analyzed in a prospective and observational study. To analyze the change in nutritional status, geriatric nutritional risk index of the patients was calculated on the day of TAVR and at 3-month follow-up. The impact of the change in nutritional risk index after TAVR on all-cause mortality, heart failure hospitalization (HF-h), and the composite of all-cause death and HF hospitalization was analyzed using the Cox Proportional Hazards model. Results: Four hundred thirty-three patients were included. After TAVR, 68.4% (n=182) patients with baseline nutritional risk improved compared with 31.6% (n=84) who remained at nutritional risk. The change from no-nutritional risk to nutritional risk after TAVR occurred in 15.0% (n=25), while 85.0% (n=142) remained without risk of malnutrition. During follow-up, 157 (36.3%) patients died and 172 patients (39.7%) were hospitalized due to HF. Patients who continued to be at nutritional risk had a higher risk of mortality (hazard ratio [HR], 2.10 [95% CI, 1.30–3.39], P =0.002), HF-h (HR, 1.97 [95% CI, 1.26–3.06], P =0.000), and the composite of death and HF-h (HR, 2.0 [95% CI, 1.37–2.91], P <0.001). The change to non-nutritional risk after TAVR significantly impacted mortality (HR, 0.48 [95% CI, 0.30–0.78], P =0.003), HF-h (HR, 0.50 [95% CI, 0.34–0.74], P =0.001), and the composite outcome (HR, 0.44 [95% CI, 0.32–0.62], P <0.001). Conclusions: Remaining at nutritional risk after TAVR confers a poor prognosis and is associated with an increased risk of mortality and HF-h, while the change from risk of malnutrition to non-nutritional risk after TAVR was associated with a halving of the risk of mortality and HF-h. Further studies are needed to identify whether patients at nutritional risk would benefit from nutritional intervention during processes of care of TAVR programs.
No takes yet. Share an insight, caveat, or question.
González-Ferreiro et al. (2021) conducted an observational in Transcatheter aortic valve replacement (TAVR) (n=433). Change to non-nutritional risk vs. Remaining at nutritional risk was evaluated on Composite of all-cause death and heart failure hospitalization (HR 0.44, 95% CI 0.32-0.62, p=<0.001). Changing from nutritional risk to non-nutritional risk after TAVR was associated with a reduced risk of the composite of death and heart failure hospitalization (HR 0.44; 95% CI 0.32-0.62; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: