Clinical implications of malnutrition on 30-day adverse events in patients with Takotsubo syndrome.

Abstract

Background: The impact of malnutrition on clinical outcomes in patients with takotsubo syndrome (TTS) is poorly understood. The purpose of this study was to investigate the relationship between malnutrition on admission and 30-day adverse events in patients with TTS.

Methods: We retrospectively evaluated 124 consecutive patients admitted for TTS at our hospital from April 2013 to July 2023. Malnutrition was assessed at admission using the Geriatric Nutritional Risk Index (GNRI), which is an objective and simple nutritional assessment method. Malnutrition was defined as GNRI <92. We defined 30-day adverse events as the composite of all-cause death, acute heart failure, cardiogenic shock, life-threatening arrhythmia, thrombotic events, and stroke. The primary endpoint was the comparison of the 30-day adverse event rates between patients with and without malnutrition.

Results: The median age was 78.0 (70.0-83.0) years, and 77 % of the patients were women. The median GNRI was 90.8 (81.5-98.0) and 55 % had malnutrition. The 30-day adverse events were shown in 64 patients. Compared with patients without malnutrition, the 30-day adverse event rate was significantly higher in those with malnutrition (32 % vs. 68 %, respectively; log-rank test p = 0.0001). The multivariable Cox proportional hazards model revealed that malnutrition was independently associated with high 30-day adverse event rates adjusted by age, female sex, malignancy, B-type natriuretic peptide, and high-sensitivity C-reactive protein (hazard ratio: 1.97, 95 % confidence interval: 1.08-3.58; p = 0.02).

Conclusions: Malnutrition at admission was associated with high 30-day adverse event rates. Early identification and a considered treatment strategy for malnutrition are important in patients with TTS.