Key result
Preoperative malnutrition plus sarcopenia is linked to a ~3-fold higher post-TAVR mortality risk.
Why the study?
The impact of coexisting malnutrition and sarcopenia on survival after TAVR had not been fully studied.
Does the coexistence of preoperative malnutrition and sarcopenia increase the risk of all-cause death in patients undergoing TAVR?
Observational (n=340)
No
Does the coexistence of preoperative malnutrition and sarcopenia increase the risk of all-cause death in patients undergoing TAVR?
Hazard Ratio: 3.15 (95% CI 1.68–5.89)
Absolute Event Rate: 64% vs 37%
p-value: p=<0.001
The coexistence of preoperative malnutrition and sarcopenia strongly predicts increased all-cause mortality after TAVR, highlighting the need for comprehensive geriatric assessment and risk stratification.
May support preoperative geriatric screening in TAVR; hypothesis-generating and requires prospective validation before practice change.
Background: The impact of coexisting malnutrition and sarcopenia on survival after transcatheter aortic valve replacement (TAVR) has not been fully studied. Methods and Results: Among 513 consecutive patients undergoing TAVR between February 2014 and June 2023, 340 with available preoperative Geriatric after Nutritional Risk Index (GNRI) and Short Physical Performance Battery (SPPB) data were categorized into 4 groups based on malnutrition (GNRI <98) and sarcopenia (SPPB ≤9) status: malnutrition and sarcopenia (N=98); malnutrition without sarcopenia (N=69); no malnutrition with sarcopenia (N=83); neither malnutrition nor sarcopenia (N=90, reference). The primary outcome measure was all-cause death. Patients with both malnutrition and sarcopenia were older and had a higher prevalence of anemia compared with the reference group. The cumulative 5-year mortality rate was significantly higher in this group. After adjusting for confounders, coexistence of malnutrition and sarcopenia had a significantly higher risk for all-cause death (hazard ratio [HR] 3.15; 95% confidence interval [CI]: 1.68-5.89; P<0.001). In contrast, malnutrition without sarcopenia (HR 1.36; 95% CI 0.64-2.90; P=0.42) and no malnutrition with sarcopenia (HR 1.86; 95% CI 0.92-3.79; P=0.08) were not associated with increased mortality. Conclusions: The coexistence of malnutrition and sarcopenia significantly increased mortality risk after TAVR, which highlights the importance of integrating both nutritional and sarcopenia assessments into preoperative risk stratification to optimize outcomes in patients undergoing TAVR.
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Nakamura et al. (2026) conducted an observational in Severe aortic stenosis (n=340). Coexisting malnutrition and sarcopenia vs. Neither malnutrition nor sarcopenia was evaluated on All-cause death (HR 3.15, 95% CI 1.68-5.89, p=<0.001). The coexistence of preoperative malnutrition and sarcopenia significantly increased the risk of all-cause death after transcatheter aortic valve replacement compared to patients with neither condition (adjusted HR 3.15).
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