Nutritional Status Is Associated with Mortality but Not Appropriate Discharge of Implantable Cardioverter Defibrillators in Patients with Heart Failure


YAKUT İ., KANAL Y., Aksoy A., Ozeke O., Ozcan O. U., Ozen Y., ...Daha Fazla

Diagnostics, cilt.15, sa.5, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 5
  • Basım Tarihi: 2025
  • Doi Numarası: 10.3390/diagnostics15050610
  • Dergi Adı: Diagnostics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, INSPEC, Directory of Open Access Journals
  • Anahtar Kelimeler: CONUT score, heart failure, ICD, malnutrition, PNI
  • Sivas Cumhuriyet Üniversitesi Adresli: Evet

Özet

Objective: To investigate the predictive value of nutritional status in heart failure (HF) patients with an implantable cardioverter defibrillator (ICD), and to identify factors associated with ICD discharge and mortality. Methods: This retrospective study was conducted by analyzing data from 2017 to 2021. HF patients who underwent ICD implantation for primary prevention were included. Follow-up visits were continued until December 2022. Patients were examined based on ICD shock occurrence (ICD-A: appropriate shock), ICD non-discharge (ICD-X), and mortality. Nutritional status was assessed by the Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status (CONUT) scores. Results: A total of 221 patients were included in the study, 86 of whom were in the ICD-A group (135 in the ICD-X group). Age and sex distribution were similar in these groups. The all-cause mortality rate was 20.36%. A PNI with a cut-off value of <47.25 and a CONUT score with a cut-off value of >2.5 were able to significantly predict all-cause mortality. The PNI had a greater area under the curve compared to the CONUT. Non-ischemic cardiomyopathy and high left-ventricle end-systolic diameter (ESD) were independently associated with appropriate ICD shock. Low systolic blood pressure, high ESD, low sodium, low total cholesterol, low (<47.25) PNI, and ICD shock were independently associated with all-cause mortality. Conclusions: Malnutrition appears to be associated with mortality in patients with primary-prevention ICDs, and the PNI appears to be a more useful indicator than the CONUT for determining the risk of mortality in these patients.