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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
5 days ago
In patients with type 2 diabetes, obesity may be protective against vision-threatening diabetic retinopathy, a recent Korea study has shown.
Roshini Claire Anthony, 4 days ago

Men with metastatic hormone-sensitive prostate cancer (mHSPC) who receive testosterone suppression therapy may have a better survival outcome with the addition of enzalutamide over other non-steroidal anti-androgen (NSAA) therapies, according to the phase III ENZAMET* trial.

07 Jun 2019
Low-dose aspirin therapy does not confer significant benefits to elderly patients with hypertension, but treatment appears to increase the risk of haemorrhagic events, suggest a Japan study.
4 days ago
The use of opioids may have limited long-term efficacy in the management of chronic noncancer pain, reports a new study.