Malnutrition ups mortality risk after transcatheter aortic valve replacement
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.