Effects of Early Postoperative Whey Protein Isolate-Based Oral Supplementation on Nutritional Outcomes in Patients Undergoing Coronary Artery Bypass Grafting: A Prospective Multicentre Real-World Study

BackgroundCoronary artery bypass grafting (CABG) triggers inflammatory and catabolic responses, increasing the risk of postoperative nutritional deficits.Whey protein isolate (WPI) may improve recovery and muscle strength.This study evaluated the impact of early postoperative WPI-based supplementation on nutritional outcomes among CABG patients. MethodologyThis open-label, single-arm, prospective real-world study enrolled 200 adult patients undergoing CABG at two tertiary care centres in India.Patients received a WPI-based oral nutritional supplement starting 24-48 hours post-surgery and continued for 30 days post-discharge.Outcomes included protein and calorie adequacy, nutritional status, change in weight, hand-grip strength, safety, and patient and physician experiences with the WPI-based nutritional supplement.Data were analysed using appropriate parametric and nonparametric tests. ResultsOf the 200 patients enrolled, 182 (91.0%) completed the study.They were included in the intent-to-treat (ITT) group, while 119 (59.5%) adhered to the protocol, completed the 30-day follow-up visit, and were included in the per-protocol (PP) group.Compared with the day of supplement initiation (Visit 1), the proportion of patients achieving calorie and protein adequacy at the end of the study (EOS) increased significantly (calorie adequacy: ITT (n = 34, 18.7%) vs. (n = 143, 81.3%); PP (n = 3, 2.5%) vs. (n = 105, 88.2%); protein adequacy: ITT (n = 41, 22.5%) vs. (n = 140, 76.9%); PP (n = 5, 5.0%) vs. (n = 99, 83.2%); all P < 0.001).An increase in weight was observed in both groups (P < 0.05), with a greater proportion of patients experiencing weight gain in the PP group (n = 60, 50.0%) than in the ITT group (n = 55, 30.0%) at EOS. Handgrip strength (HGS) also improved from the day of discharge (Visit 3) to EOS (HGS weak: ITT (n = 130, 71.4%) vs. (n = 71, 39.0%) (P < 0.001); PP (n = 85, 71.4%) vs. (n = 38, 31.9%)(P < 0.001); HGS normal: ITT (n = 43, 23.6%) vs. (n = 85, 46.7%) (P < 0.001); PP (n = 31, 26.1%) vs. (n = 65, 54.6%) (P < 0.001); HGS strong: ITT (n = 9, 5.0%) vs. (n = 26, 14.3%) (P < 0.05); PP (n = 3, 2.5%) vs. (n = 16, 13.5%) (P < 0.05)).No related safety events were recorded. ConclusionsEarly WPI-based oral supplementation initiated within 48 hours post-CABG and continued for 30 days increases protein and calorie adequacy, nutritional outcomes, supported weight gain, and supported muscle strength recovery without safety concerns.These findings support incorporating early protein supplementation into postoperative care protocols.