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Heart failure

Malnutrition in Heart Failure Patients Linked to Poor Prognosis

Strategic Insights

— 2 min read

New research has found that malnutrition is prevalent among heart failure patients in China, and is associated with poor prognosis. The study, published in the journal Nutrition, Metabolism and Cardiovascular Diseases, assessed the prognostic value of the Geriatric Nutritional Risk Index (GNRI) in acute heart failure (AHF) patients. The research team, led by Yaoyao Wang from Fuwai Hospital, included 4314 eligible AHF patients from a nationwide prospective cohort in China. The study found that malnutrition, defined as a GNRI score of 98, was associated with increased risks of all-cause mortality, cardiovascular mortality, major adverse cardiovascular events, and hospitalization for heart failure.

Key Takeaways:

  • The study included 4314 eligible AHF patients from a nationwide prospective cohort in China.
  • Malnutrition, defined as a GNRI score of 98, was associated with increased risks of all-cause mortality (HR 1.48, 95% CI 1.34-1.63), cardiovascular mortality (HR 1.42, 95% CI 1.26-1.60), and major adverse cardiovascular events (HR 1.25, 95% CI 1.10-1.42).
  • The GNRI score demonstrated an inverse linear association with mortality risk, consistent across left ventricular ejection fraction, gender, and estimated glomerular filtration rate levels.
  • Adding GNRI to the multivariate model improved its predictive accuracy for all-cause mortality (C-index 0.700 vs. 0.692) and cardiovascular mortality (C-index 0.711 vs. 0.706).
  • Lower GNRI scores increased the risks of adverse outcomes in AHF patients and provided superior additional prognostic value for mortality prediction compared with body mass index or serum albumin alone.

Statistics:

  • 4314 eligible AHF patients were included in the study.
  • Malnutrition, defined as a GNRI score of 98, was associated with a 48% increased risk of all-cause mortality.
  • The GNRI score demonstrated an inverse linear association with mortality risk, indicating that lower scores were associated with increased mortality risk.
  • The C-index for all-cause mortality improved from 0.692 to 0.700 when GNRI was added to the multivariate model.
  • The C-index for cardiovascular mortality improved from 0.706 to 0.711 when GNRI was added to the multivariate model.

Sources:

  • Wang Y, et al. The relationship between geriatric nutritional risk index and prognosis in acute heart failure. Nutrition, Metabolism and Cardiovascular Diseases, 2025:104268.
  • Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, 100037, Beijing, People's Republic of China.
  • Elsevier Sci Ltd, 125 London Wall, London, England. (Elsevier - www.elsevier.com; Nutrition, Metabolism and Cardiovascular Diseases - www.journals.elsevier.com/nutrition-metabolism-and-cardiovascular-diseases/)

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