Malnutrition negatively affects outcomes in AMI patients undergoing revascularization

Acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI) are at heightened risk of malnutrition, which is in turn associated with increased incidence of major bleeding, all-cause death, and major ischaemic event, according to data from the COREA-AMI registries.

The COREA-AMI registries included 10,161 AMI patients who underwent PCI. Patients with geriatric nutritional risk index (GNRI) scores of <82, 82 to <92, 92 to <98, and ≥98 were deemed to have severe, moderate, mild, and no malnutrition risk, respectively.

Researchers evaluated the associations of GNRI with Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding, all-cause death, and major cardiovascular events (MACEs; defined a composite of cardiovascular death, myocardial infarction, or ischaemic stroke).

Of note, more than half of the patients were malnourished, with 25.0 percent having mild malnutrition risk, 22.7 percent having moderate risk, and 4.9 percent having severe risk. Over a median 4.9-year follow-up, all three outcomes occurred more frequently among patients with vs without malnutrition.

Multivariable Cox analysis confirmed that the presence of malnutrition was associated with higher risks of BARC 3 or 5 bleeding (adjusted hazard ratios [aHRs], 1.27, 1.55, and 2.02 for mild, moderate, and severe malnutrition, respectively; p<0.001), all-cause death (aHRs, 1.26, 1.46, and 1.85 for mild, moderate, and severe malnutrition, respectively; p<0.001), and MACEs (aHRs, 1.14, 1.32, and 1.67 for mild, moderate, and severe malnutrition, respectively; p<0.001).

The findings indicate that malnutrition has adverse clinical impact on PCI outcomes in AMI patients.