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Malnutrition ups mortality risk after transcatheter aortic valve replacement

12 Jan 2019
In intermediate risk patients, the TAVR is found to have better outcomes

The nutritional risk index (NRI) is significantly predictive of long-term mortality risk after transcatheter aortic valve replacement (TAVR), a new study reports.

Researchers conducted a retrospective multicentre study including 941 patients who underwent TAVR. Participants were categorized according to malnutrition risk: severe (NRI <83.5; n=83), moderate (NRI 83.5 to <97.5; n=370), mild (NRI 97.5 to <100; n=102) and no risk (NRI 100; n=386).

Over a mean follow-up period of 2.1±1.1 years, 186 mortality events were recorded, resulting in an overall mortality rate of 19.8 percent. This value was significantly higher in participants with moderate or severe malnutrition vs no or mild malnutrition (11.5 vs 6.7 per 100 person/year; p<0.001).

The difference in mortality rate was driven primarily by deaths from noncardiovascular causes, which were significantly more frequent in those with moderate or severe malnutrition (12.8 percent vs 6.8 percent; p<0.001). Cardiovascular mortality was comparable between groups (p=0.555).

Multivariate Cox regression analysis revealed that NRI, when taken as a continuous variable, was significantly and inversely associated with mortality (hazard ratio [HR], 0.98 for each additional point; 95 percent CI, 0.96–0.99; p=0.019). Similarly, all-cause mortality risk was significantly elevated in those with moderate or severe malnutrition risk (HR, 1.45; 1.05–1.099; p=0.021).

The present findings highlight the potential of NRI as a predictor of mortality risk in patients who undergo TAVR, said researchers. This suggests that malnutrition is a modifiable risk factor that can be clinically targeted and managed in this population.

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Most Read Articles
4 days ago
No association exists between physical activity and the risk of urological cancer, according to a population-based prospective study in Japan.
5 days ago
Patients with childhood-onset inflammatory bowel disease are more likely to die than the general population, a study suggests.
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Reduced caloric intake results in a significant improvement in glucose metabolism and body-fat composition, including liver-fat content, according to a study. Changes in ferritin levels appear to mediate the striking reduction in liver fat.
Pearl Toh, 5 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.