title: Influence of undernutrition at admission on clinical outcomes in patients with acute myocardial infarction.
abstract: Although the effect of overweight or obesity on clinical outcomes in patients with acute myocardial infarction (MI) has been reported, the effect of undernutrition is not as well understood. Therefore, we investigated whether acute MI patients frequently present with undernutrition, and whether this influences poor clinical outcomes.
  
  
  
  Using the Korea Acute Myocardial Infarction Registry database, we screened initial data on acute MI patients admitted within 48h of symptom onset to a tertiary university hospital between November 1, 2011 and May 31, 2015. We then assessed nutritional status at admission, using the Geriatric Nutritional Risk Index (GNRI). Of a total of 2251 patients, there were 1585 (70.4%) men, and mean age was 65.0±12.8 years. Based on GNRI score, undernutrition at admission was present in 409 (18.2%) patients. Multiple logistic regression analysis found undernutrition to be an independent factor influencing post-MI complications [odds ratio (OR), 2.13; 95% confidence interval (CI), 1.61-2.84; p<0.001], after adjusting for age, sex, hypertension, diabetes, hyperlipidemia, previous stroke, smoking, diagnosis, number of involved vessel lesions, Killip class, atrial fibrillation, baseline blood pressure, hemoglobin, creatine kinase-MB, creatinine, performance of percutaneous coronary intervention, reperfusion time, recanalization, and use of antithrombotics. Undernutrition was also an important factor influencing in-hospital death (OR, 2.48; 95% CI, 1.55-3.95; p<0.001), after adjusting for all potential factors by univariate analysis.
  
  
  
  Nutritional status is a significant prognostic factor in clinical outcomes after MI during hospitalization. Therefore, nutritional assessment and intervention, especially for undernourished MI patients, should be considered.
authors: College of Nursing, Chonnam National University, Gwangju, Republic of Korea.
authors: Sung Hee
authors: SH
authors: Yoo
authors: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Hyun Yi
authors: HY
authors: Kook
authors: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Young Joon
authors: YJ
authors: Hong
authors: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Ju Han
authors: JH
authors: Kim
authors: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Youngkeun
authors: Y
authors: Ahn
authors: Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address: myungho@chollian.net.
authors: Myung Ho
authors: MH
authors: Jeong
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Complications; Mortality; Myocardial infarction; Undernutrition