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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
Roshini Claire Anthony, 5 days ago

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
4 days ago
Discontinuing the use of tyrosine kinase inhibitors (TKIs) in the treatment of patients with chronic myeloid leukaemia appears to be feasible in real-life clinical practice in the context of close molecular monitoring, a study reports.
5 days ago
There appears to be no clear link between pornography use, even at problematic levels, and erectile dysfunction, a recent US study has shown.