Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database

Jin Lu; Zhidong Huang; Junjie Wang; Xiaoli Zhao; Yanfang Yang; Bo Wu; Yu Kang; Jiaming Xiu; Jiabin Tu; Yuxiong Pan; Weihua Chen; Kunming Bao; Liling Chen; Jin Liu; Yong Liu; Shiqun Chen; Yong Fang; Kaihong Chen

doi:10.3389/fnut.2022.890199

Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database

Front Nutr. 2022 Jun 15:9:890199. doi: 10.3389/fnut.2022.890199. eCollection 2022.

Authors

Jin Lu¹, Zhidong Huang², Junjie Wang¹, Xiaoli Zhao³, Yanfang Yang¹, Bo Wu¹, Yu Kang², Jiaming Xiu¹, Jiabin Tu¹, Yuxiong Pan¹, Weihua Chen¹, Kunming Bao¹, Liling Chen¹, Jin Liu², Yong Liu², Shiqun Chen², Yong Fang¹, Kaihong Chen¹

Affiliations

¹ Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.
² Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Malnutrition is associated with poor prognosis in patients with acute myocardial infarction (AMI). However, the prognostic impact of malnutrition in critical patients with AMI has not been well addressed.

Methods: We analyzed two critical AMI cohorts from Cardiorenal ImprovemeNt (CIN) in China and Medical Information Mark for Intensive Care-III (MIMIC-III) in the United States. The primary outcome was all-cause mortality. Cox proportional hazards models were constructed to examine the risk of malnutrition for mortality in critical patients with AMI.

Results: There were 2,075 critical patients with AMI (mean age, 62.5 ± 12.3 years, 20.00% were female) from the CIN cohort and 887 critical patients with AMI (mean age, 70.1 ± 12.9 years, 37.43% were female) from MIMIC-III included in this study. Based on the Controlling Nutritional Status (CONUT) score, of the Chinese patients with AMI, the prevalence was 47.5, 28.3, and 3.5% for mild, moderate, and severe malnutrition, respectively. The percentage of mild, moderate, and severe malnutrition was 41.60, 30.55, and 7.32% in the MIMIC-III cohort, respectively. Controlling for confounders, worse nutritional state was significantly associated with increased risk for all-cause mortality [an adjusted hazard ratio for mild, moderate, and severe malnutrition, respectively, 1.10 (95% confidence interval (CI): 0.76-1.59), 1.49 (95% CI: 1.02-2.19), and 1.70 (95% CI: 1.00-2.88) in the CIN cohort and 1.41 (95% CI: 0.95-2.09), 1.97 (95% CI: 1.32-2.95), and 2.70 (95% CI: 1.67-4.37) in the MIMIC-III cohort].

Conclusion: Malnutrition was independently associated with an increased risk of all-cause mortality in critical patients with AMI after full adjustments. Further trials are needed to prospectively evaluate the efficacy of nutritional interventions in critical patients with AMI.

Keywords: Controlling Nutritional Status (CONUT) score; MIMIC-III database; all-cause mortality; critical acute myocardial infarction; malnutrition.