Malnutrition and mortality in patients ≥ 75 years with chronic heart failure

INTRODUCTION: Malnutrition is common in patients with heart failure (HF) but its prognostic impact in advanced age patients remains unsettled. We sought to prospectively assess the impact the Mini Nutritional Assessment-Short Form (MNA-SF), in elderly patients with chronic HF. PATIENTS AND METHODS: We analyzed data from the FRAGIC study a multicentre prospective registry conducted across 16 cardiology departments in Spain that included HF outpatients aged ≥75 years. RESULTS: From 499 patients (mean age 81.4±4.3 years, 192 [38%] women), 235 had MNA-SF ≤11 (47%). Compared with patients with normal nutritional status, these patients were older (82±7 vs. 81±7, p=0.047), more frequently women (45% vs. 33%, p=0.005), and frail (66% vs. 43%, p=<.001), and showed a more advanced functional class (NYHA≥II 90% vs. 80%, p=0.03) and higher natriuretic peptide levels (NTproBNP>1000pg/ml: 77% vs. 65%, p=0.005). During a median follow-up of 371 days, 58 patients (11.6%) died. One-year mortality was higher in patients with worse nutritional status (39 [17%] vs. 19 [7.2%], p=0.001), which was independently associated with one-year mortality (hazard ratio 1.97, 95% confidence interval 1.09-3.55, p=0.02). CONCLUSION: A MNA-SF score≤11 is common in older patients with chronic HF and it is associated with higher mortality at one-year follow-up.