Interrelationship between Altered Left Ventricular Ejection Fraction and Nutritional Status in the Post-Acute Myocardial Infarction Patient.

There is currently little research on the effects of reduced left ventricular ejection fraction and altered nutritional status in patients with acute myocardial infarction. We therefore examined the interrelationship between the parameters of left ventricular dysfunction after acute myocardial infarction and changes in the Geriatric Nutrition Risk Index (GNRI) and the Nutrition Status Control Index (CONUT). Based on the evidence, frailty is considered to be an important factor affecting the prognosis of cardiovascular disease, so it is important to detect malnutrition early to prevent adverse cardiovascular events. This study was an observational, prospective study that included a total of 73 subjects who presented at the 3-month AMI follow-up. All subjects were subjected to laboratory tests and the groups were divided as follows: group 1, in which we calculated the CONUT score, (CONUT < 3 points, n = 57) patients with normal nutritional status and patients with moderate to severe nutritional deficiency (CONUT ≥ 3, n = 16). In group 2, the GNRI score was calculated and out of the 73 patients we had: GNRI ≥ 98, n = 50, patients with normal nutritional status, and GNRI < 98, n = 23, patients with altered nutritional status. The results of this study showed that we had significant differences between LVEF values at 3 months post-infarction where, in the CONUT group, patients with altered nutritional status had lower LVEF values (46.63 ± 3.27% versus 42.94 ± 2.54%, p < 0.001) compared to CONUT < 3. Also, in the GNRI group, we had lower LVEF values in patients with impaired nutritional status (46.48 ± 3.35% versus 44.39 ± 3.35%, p = 0.01). It can be seen that LVEF values are improved at 3 months post infarction in both groups, in patients with impaired nutritional status and in patients with good nutritional status. Patients with impaired nutritional status have lower ejection fraction and worse outcomes in both the CONUT and GNRI groups at 3 months post acute myocardial infarction.

Altered nutritional status, inflammation and systemic vulnerability in patients with acute myocardial infarction undergoing percutaneous coronary revascularisation: A prospective study in a level 3 cardiac critical care unit.

AIM: The aim of the present study was to assess the influence of nutritional status, as expressed by Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) scores, on the inflammatory response following acute myocardial infarction (AMI) and the impact of an altered nutritional status and increased systemic inflammation on immediate evolution following AMI. METHODS: This was an observational prospective study in which we used the CONUT score and GNRI on 86 consecutive patients with AMI receiving primary revascularisation, divided into a well-nourished group (CONUT score 0-2, n = 68) and moderate-to-severe nutritional deficit group (CONUT score ≥ 3, n = 18). Inflammatory status was assessed on the basis of highly sensitive C-reactive protein (hs-CRP) at baseline and on day 5. RESULTS: Malnourished patients presented significantly higher levels of serum hs-CRP at baseline (33.6 ± 35.02 mg/dL vs 10.26 ± 25.93 mg/dL, P < 0.0001) and day 5 (52.8 ± 46.25 mg/dL vs 17.04 ± 24.78 mg/dL, P < 0.0001). GNRI values showed a weak but significant correlation with serum hs-CRP at baseline (r = -0.26, P = 0.01) and day 5 (r = -0.44, P < 0.0001). Patients with altered nutritional status presented more frequent deterioration of their haemodynamical status, requiring inotropic support (P = 0.002) and longer hospitalisation in the acute cardiac care unit (4.27 ± 2.60 vs 2.85 ± 0.73 days, P = 0.005). Patients requiring intravenous inotropics had a higher CONUT score (2.31 ± 1.7 vs 1.17 ± 1.27, P = 0.01), lower GNRI (102.0 ± 5.31 vs 98.56 ± 5.2, P = 0.02) and higher hs-CRP levels at baseline and day 5 (31.40 ± 46.57 vs 18.52 ± 32.98, P = 0.04 and 46.04 ± 51.50 vs 19.60 ± 46.05, P = 0.006). CONCLUSIONS: Malnourished patients with AMI had more expressed inflammation, increased blood vulnerability and worse outcomes.