P3434Impact of nutritional status in elderly patients with acute myocardial infarction

Abstract

Background: Malnutrition is a common condition in the elderly population and is associated with reduced physical performance, prolonged hospitalization and increased mortality. However, the prevalence and impact of malnutrition among elderly patients with acute myocardial infarction (AMI) is still poorly studied. Methods and results: We prospectively enrolled 167 consecutive elderly patients (age≥65 yrs; mean age=73,7±6,6 yrs) admitted at Intensive Coronary Care Unit (ICCU) for AMI (51,4% STEMI). De-mographic, clinical, laboratoristic and echocardiography data were collected at the time of ICCU admission, together with questioners included in the geriatric multidimensional evaluation (i.e. Mini nutritional assessment [MNA], ADL, IADL, SPMSQ, Exton-Smith, CIRS). According to MNA score, 73 patients (51,4%) presented a good nutritional status (MNA≥24) while 14 (9,9%) presented malnutrition (MNA<17) and 55 (38,7%) were at risk for malnutrition. Dichotomizing our study population in two groups, malnutrition plus at risk for malnutrition (69 patients, 48,6%) and good nutritional status (73 patients, 51,4%), we found that these two groups were homogeneous for demographic characteristics and clinical, laboratoristic and instrumental data, but were different for the majority of the geriatric scales measured (Table). Importantly, poor nutritional status was associated with higher 6-month mortality rate (26,1% vs 5,5%; p<0,001). At multivariate cox regression analysis, among 13 variables tested MNA emerged as independent predictor of short-term mortality, together with GRACE score, LVEF and type of AMI (Table). Kaplan-Mayer Survival analysis confirmed that the group with good nutritional status had a significant better survival compared to the group with malnutrition or at risk for malnutrition (longrank p<0,001). Conclusions: Nutritional status is an independent predictor of short-term mortality among elderly patients with AMI. Measurement of MNA score in elderly patients with AMI may help prognostic stratification and identification of patients with/at risk of malnutrition in order to apply interventions to improve nutritional status.