Key result
Severe malnutrition, indicated by a CONUT score ≥5, was an independent predictor of major adverse cardiovascular events (HR 2.50) in patients with STEMI treated with primary PCI.
Why the study?
The effect of malnutrition in patients with STEMI is not fully understood, motivating an investigation into the prognostic value of the Controlling Nutritional Status score.
Does a high CONUT score predict major adverse cardiovascular events in patients with STEMI treated with primary PCI?
Cohort (n=1,028)
No
Does a high CONUT score predict major adverse cardiovascular events in patients with STEMI treated with primary PCI?
Hazard Ratio: 2.5 (95% CI 1.61–3.9)
Absolute Event Rate: 33.3% vs 10.9%
p-value: p=<0.001
Severe malnutrition, as assessed by a CONUT score ≥5, is a strong independent predictor of major adverse cardiovascular events in patients with STEMI undergoing primary PCI.
CONUT score may refine STEMI risk stratification; leaves open whether nutritional interventions improve outcomes.
OBJECTIVE: The effect of malnutrition in patients with ST segment elevation myocardial infarction (STEMI) is not fully understood. In this study, we tried to investigate the prognostic consequence of the Controlling Nutritional Status (CONUT) score in patients with STEMI. METHODS: In this study, we evaluated the CONUT scores of 1,028 patients with STEMI and examined its relationship with major adverse cardiovascular events (MACE) (all-cause mortality, myocardial reinfarction, and vessel revascularization) during a period of 19.9±10.3 months. Patients with CONUT score ≥5 were defined as severely malnourished. Predictors of MACE were assessed by Cox regression analysis, and p<0.05 was considered to indicate statistical significance. RESULTS: MACE was observed in a total of 147 (14.3%) patients. MACE was more frequent in the group with a higher CONUT score (33.3% vs. 10.9%, p<0.001). CONUT score ≥5 was an independent predictor of MACE in the Cox regression analysis (hazard ratio=2.50, 95% confidence interval: 1.61-3.90, p<0.001). Low ejection fraction, Killip class ≥3 at presentation, thrombolysis in myocardial infarction flow grade <3 after intervention, left main artery involvement, and low hemoglobin levels were other independent predictors of MACE in the long-term follow-up. Kaplan-Meier curves showed decreased MACE free survival rates in the high CONUT score group at a mean 19.9±10.3 months' follow-up duration (log-rank p<0.01). CONCLUSION: Malnutrition was strongly associated with poor outcomes in patients with STEMI treated using primary percutaneous coronary intervention.
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Zengin et al. (2021) conducted a cohort in ST segment elevation myocardial infarction (STEMI) (n=1,028). Controlling Nutritional Status (CONUT) score ≥5 vs. CONUT score <5 was evaluated on Major adverse cardiovascular events (MACE) including all-cause mortality, myocardial reinfarction, and vessel revascularization (HR 2.50, 95% CI 1.61-3.90, p=<0.001). Severe malnutrition, indicated by a CONUT score ≥5, was an independent predictor of major adverse cardiovascular events (HR 2.50) in patients with STEMI treated with primary PCI.
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