Background and aims
Recent evidence showed that malnutrition is an important poor prognostic factor for cardiovascular (CV) disease. Malnutrition is often considered a consequence of a state of undernutrition and, therefore, is believed to only affect underweight people. In fact, a major malnutrition problem affects the overweight and obese population due to inadequate consumption of micronutrients and poor food quality. This study sought to report the prevalence, clinical associations, and short-term prognostic consequences of malnutrition in patients with acute coronary syndrome (ACS).
Methods
This is a prospective observational pilot study that includes patients with a final diagnosis of ACS admitted consecutively to the UTIC of the Santo Stefano hospital in Prato. All patients (all spectrum ACS) are subjected to an early invasive strategy and treated with routine pharmacological therapy. In all cases the standard prevention protocol against contrast-induced acute kidney injury is applied. On admission, we measure: anthropometric parameters, indirect measurement of lipid and protein reserve; body composition with BIVA method; routine blood tests. The following nutritional indices are calculated: the Controlling Nutritional Status score (CONUT), the Nutritional Risk Index (NRI) and the Prognostic Nutritional Index score (PNI). Clinical end-points are: incidence of acute kidney injury (defined as an increase in serum creatinine ≥ 0.3 mg/dl within 48 hours of the invasive procedure); maximum increase in high sensitivity C reactive protein value; maximum decrease in hemoglobin value. During hospitalization, death, re-infarction, acute heart failure are recorded as major adverse clinical events.
Results
The study, which began on November 1, 2023, plans to enroll 120 consecutive patients. The prevalence of the state of malnutrition will be evaluated according to the various indices and its association with the pre-established clinical end-points will be analyzed.
Conclusions
The results will allow us to establish whether the evaluation of malnutrition in patients with ACS is decisive in quantifying the risk of complications, evaluating the response to therapy and impacting the prognosis. The results of this study will be presented and discussed at the congress.