Impact of the Geriatric Nutritional Risk Index in Patients Undergoing Transcatheter Aortic Valve Implantation
Section snippets
Methods
We retrospectively reviewed 1681 consecutive patients with severe AS who underwent TAVI at the Cedars-Sinai Medical Center between November 2013 and December 2017. Transthoracic echocardiography was performed to assess the severity of AS. All patients were diagnosed with severe AS with aortic valve area (AVA)<1.0 cm2, mean pressure gradient≥40 mmHg, or peak velocity≥4.0 m/s. Informed consent was obtained from all patients prior to the TAVI procedure. All data were collected from an established
Results
The baseline characteristics of the study patients are shown in Table 1. The mean age of the entire cohort was 82.1±7.1 years, with 81% of the participants being older than 75 years of age. The median STS score was 4.8, and 58% of the patients were male. The flowchart of patient exclusion in this study is shown in Figure 1. Among 1681 patients, 713 were excluded according to the exclusion criteria, and 968 patients were included in the analysis. The GNRI distribution in this cohort is shown in
Discussion
This is the first report of a large US population that evaluated the prognostic value of the GNRI in patients undergoing TAVI. Summarizing the findings, GNRI was independently associated with 2-year all-cause mortality and was shown to be useful for risk stratification even in younger and low-risk patients. The GNRI was first reported in 2005 by Bouillanne et al.4 to predict the risk of complications, such as bedsores, infections, and mortality associated with malnutrition, in hospitalized
Author disclosures
Dr. Makkar received grant support from Edwards Lifesciences Corporation; he is a consultant for Abbott Vascular, Cordis, and Medtronic and holds equity in Entourage Medical. Dr. Chakravarty is a consultant, proctor, and speaker for Edwards Lifesciences and Medtronic; he is a consultant for Abbott Lifesciences, and he is a consultant and speaker for Boston Scientific. Other authors have no conflicts of interest to disclose.
Acknowledgment
None.
Disclosures
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper
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Cited by (7)
Meta-Analysis on the Association Between Nutritional Status and Outcomes After Transcatheter Aortic Valve Implantation
2023, American Journal of CardiologyCitation Excerpt :All analyses were performed using R (version 4.0.2; R Foundation for Statistical Computing) and R studio (version 1.3.1073) and the packages meta and metafor. After a systematic search, 13 observational studies with a total of 6,785 patients who underwent TAVI were included in this review (Figure 1).1,4–6,11,12,14–20 Among all studies, 25.4%, 43.9%, and 36.7% were malnourished based on CONUT, GNRI, and PNI, respectively.
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2022, Journal of the American Heart Association
Funding: None.