Malnutrition in heart failure patients associated with diminished GDMT prescription rates

Announcing a new article publication for Cardiovascular Innovations and Applications journal. This study was aimed at identifying crucial gaps in guideline-directed medical therapy (GDMT) application among malnourished patients at Beijing Anzhen Hospital. Data from patients with heart failure (HF) admitted between January 1, 2018, and April 30, 2023, were analyzed.

Malnutrition was assessed with Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) scores. GDMT regimens were defined as follows. The triple-therapy regimen included β-blockers, renin-angiotensin system inhibitors (RASIs), and mineralocorticoid receptor antagonists (MRAs). Dose-optimized triple therapy consisted of β-blockers, RASIs, and MRAs, each at ≥50% of the target doses. Dose-optimized double therapy was defined as any two of the three therapies administered at ≥50% of the target doses. Multivariable logistic regression analyses were conducted to examine the relationship between malnutrition and GDMT prescription.

Among 1397 patients, malnutrition was associated with lower prescription rates of triple-therapy (CONUT: OR 0.70, 95% CI 0.54-0.91; GNRI: OR 0.63, 95% CI 0.43-0.92), dose-optimized triple-therapy (CONUT: OR 0.59, 95% CI 0.36-0.97; GNRI: OR 0.35, 95% CI 0.11-1.17), and dose-optimized double-therapy (CONUT: OR 0.65, 95% CI 0.50-0.86; GNRI: OR 0.56, 95% CI 0.35-0.89) than observed in patients with normal nutrition after multivariable adjustment.

Malnutrition in hospitalized patients with HF with LVEF <50% was associated with diminished prescription rates of GDMT at discharge.