Evaluation of objective nutritional indexes as predictors of one-year outcomes after transcatheter aortic valve implantation

Background: Objective nutritional indexes have been shown to predict prognoses in some clinical settings. We aimed to investigate the prognostic values of these indexes in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: We retrospectively analyzed 95 consecutive patients who underwent TAVI at our institution from December 2013 to February 2017. As objective nutritional indexes, a controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) were calculated at baseline. The optimal cut-off values were determined using receiver operating characteristic curve analysis. According to the cut-off values, we investigated the association of these indexes with 1-year clinical outcomes including all-cause mortality and re-hospitalization due to heart failure. Results: In the Kaplan-Meier analysis, patients with a higher CONUT score and lower PNI had significantly higher incidence rates of 1-year mortality (26.9% vs. 2.9%; p < 0.001,17.4% vs. 2.0%; p = 0.011, respectively) and composite outcome of mortality and re-hospitalization due to heart failure (38.5% vs. 13.0%; p = 0.006, 39.3% vs. 11.9%; p = 0.002, respectively). On Cox hazard analysis, CONUT score and PNI were significantly associated with 1-year mortality [hazard ratio (HR): 1.91; 95% confidence interval (Cl): 1.27-2.88; p = 0.002, HR: 0.86; 95% CI: 0.75-0.99; p = 0.031, respectively] and the composite outcome (HR: 1.49; 95% CI: 1.11-2.00; p = 0.007, HR: 0.88; 95% CI: 0.80-0.97; p = 0.011, respectively). Conclusions: The CONUT score and PN1 are associated with 1-year clinical outcomes especially with 1-year all-cause mortality in patients undergoing TAVI. Moreover, the CONUT score and PNI might have better predictive values than GNRI. (C) 2019 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.