Potential role of the geriatric nutritional risk index as a novel risk factor for the development of non-valvular atrial fibrillation in patients with heart failure

• Published in: Bratislavské lékarské listy Vol. 122; no. 9; pp. 636 - 642
• Main Authors: Kaplan, M, Vuruskan, E, Altunbas, G, Yavuz, F, Kaplan, G I, Duzen, I V, Alic, E, Savcilioglu, M D, Annac, S, Bursa, N, Sucu, N M
• Format: Journal Article
• Language: English
• Published: 01-01-2021
• ISSN: 0006-9248
• DOI: 10.4149/BLL_2021_102

PURPOSEThe geriatric nutritional risk index (GNRI) is a simple and objective nutritional assessment tool for elderly patients. Lower GNRI values are associated with a worse prognosis in heart failure with reduced ejection fraction (HFrEF). Our aim is to investigate the relationship between malnutrition and follow-up cardiovascular (CV) events in HFrEF. METHODSA retrospective study was performed on 362 patients with HFrEF. The baseline GNRI was calculated at the first visit. The patients were divided into three groups according to the GNRI: >98, no-risk group; 92 to ≤98, low risk group; 82 to <92, moderate‑to‑high‑risk group. The study endpoint was a composite of follow-upCV events, including all-cause mortality, non-valvular atrial fibrillation (NVAF) , need for cardioverter defibrillator (ICD) therapy, HfrEF‑related hospitalizations and need for percutaneous coronary interventions (PCIs). RESULTSFollow-up data showed that the group with moderate-to-high risk had a significantly higher incidence of NVAF, PCIs and all-cause mortality compared to other groups (p<0.001, p: 0.026 and p0.05). Mean GNRI value was 83.3 in NVAF patients and 101.1 in patients without NVAF (p<0.001). Kaplan Meier survival analysis showed that patients from the group with moderate-to-high risk had a significantly worse survival rate (p < 0.001). In the multivariate Cox regression analysis, the group with moderate-to‑high risk (HR=3.872) and ICD implantations (HR=4.045) were associated with increased mortality. CONCLUSIONThe GNRI value may have a potential role for predicting future events, especially NVAF in patients with HfrEF (Tab. 4, Fig. 2, Ref. 27).