Abstract 17529: Controlling Nutritional Status (CONUT) Score Predicts Adverse Events in Patients With Chronic Heart Failure Following Cardiac Resynchronization Therapy

Introduction: Malnutrition and cachexia have been reported to be associated with poor outcomes in patients with chronic heart failure (CHF).

Hypothesis: This study aimed to investigate the association between malnutrition determined by the Controlling Nutritional Status (CONUT) score and adverse events in patients with CHF after cardiac resynchronization therapy (CRT).

Methods: This retrospective study evaluated 134 patients (90 male, mean age 70.6 ± 9.7 years; 31 (23%) old myocardial infarction, 57 (43%) dilated cardiomyopathy, 46 (34%) others) who underwent CRT implantation between 2004 and 2020 and were followed for at least one year after the operation (mean, 1070 ± 649 days). CONUT score was calculated in those patients before the CRT implantation. Patients with CONUT score of 0 - 4 (n = 106) were allocated to the preserved nutrition group, and those with CONUT score 5 - 12 (n = 28) were allocated to the malnutrition group. The primary endpoint was hospitalization for heart failure. The secondary endpoint was ventricular arrhythmias including both ventricular tachycardia and ventricular fibrillation, requiring anti-tachycardia pacing, cardioversion.

Results: During the follow-up period, hospitalization for heart failure occurred in 55 patients (41%). Ventricular arrhythmias occurred in 31 patients (23%), and 15(48.6%) patients required cardioversion. Kaplan-Meier survival analysis showed a higher incidence of hospitalization for heart failure (log-rank 6.55; P = 0.011) and ventricular arrhythmias (log-rank 6.55; P = 0.011) in the malnutrition group. Cox proportional hazards regression analysis revealed that malnutrition group had a higher incidence of hospitalization for heart failure (hazard ratio 2.11; 95% CI:1.14 - 3.70, P = 0.018) and ventricular arrhythmias (hazard ratio 2.53; 95% CI:1.17 - 5.19, P = 0.020).

Conclusions: Malnutrition determined by the CONUT score predicts adverse events in patients undergoing CRT implantation.