Prognostic usefulness of arm circumference and nutritional screening tools in older patients with cardiovascular disease

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 28; no. 7; pp. 743 - 748
• Main Authors: Nakamura, T., Kamiya, K., Matsunaga, A., Hamazaki, N., Matsuzawa, R., Nozaki, K., Tanaka, S., Yamashita, M., Maekawa, E., Noda, C., Yamaoka-Tojo, M., Masuda, T., Ako, J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2018
• Subjects: Adiposity; Age Factors; Aged; Anthropometry - methods; Arm - physiopathology; Arm circumference; Cardiovascular disease; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; Cause of Death; Female; Geriatric Assessment - methods; Humans; Male; Middle Aged; Nutrition Assessment; Nutritional screening tools; Nutritional Status; Older; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; eGFR; AC; Prognosis; BNP; CI; ROC; Cardiovascular disease; HR; PNI; AUC; CVD; CONUT; Nutritional screening tools; HF; Arm circumference; Older; BMI; GNRI
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2018.02.015

Arm circumference (AC) and nutritional screening tools have been shown to have prognostic capability in patients with cardiovascular disease (CVD). This study aimed to compare the prognostic predictive capabilities of AC and nutritional screening tools in older patients with CVD. The study population consisted of 949 admitted patients ≥60 years old with CVD. Patients underwent AC measurement and nutritional screening before hospital discharge. We used the controlling nutritional status index (CONUT), the geriatric nutritional risk index (GNRI), and the prognostic nutritional index (PNI) as nutritional screening tools. The end point of the study was all-cause mortality. The mean age of the study population was 72.3 ± 7.2 years, and 68.2% of the patients were male. A total of 130 deaths occurred over a median follow-up period of 2.2 years (interquartile range, 1.1–3.8 years). After adjusting for other prognostic factors, AC (hazard ratio [HR]: 0.59; p < 0.001), CONUT (HR: 0.82; p = 0.016), GNRI (HR: 0.77; p = 0.040), and PNI (HR: 0.80; p = 0.014) were significant predictors of mortality. However, adding AC to the multivariate-adjusted model (0.739 vs. 0.714, respectively; p = 0.037), but not CONUT, GNRI, or PNI (0.724, 0.717, and 0.723 vs. 0.714; p = 0.072, p = 0.306, and p = 0.127, respectively), significantly increased the area under the curve on receiver operating characteristic curve. AC, but not nutritional screening tools, plays a complementary role to preexisting prognostic factors for predicting prognosis in older patients with CVD. •Malnutrition is a prognostic risk factor in cardiovascular disease (CVD) patients.•Arm circumference (AC) is correlated with nutritional status in elderly.•We elucidated AC predicts mortality more than nutritional screening tools in CVD.•AC should be widely used as a prognostic predictor in CVD patients.