Patients with atrial fibrillation (AF) and protein energy malnutrition (PEM) had higher rates of in-hospital morbidity mortality and longer length of stay. The findings were presented at the CHEST Annual Meeting in Boston, Massachusetts.
PEM is an energy deficit caused by deficiency of all macronutrients, primarily protein. “PEM has not traditionally been linked to AF. Nevertheless, the relationship between inadequate nutritional status and AF remains largely unexplored,” wrote the authors, led by Anusha Kavarthapu.
The researchers sought to assess whether PEM (sometimes referred to as protein energy undernutrition or PEU) influenced clinical outcomes during hospitalization for AF. They conducted a retrospective study of data from the 2019 National Inpatient Sample (NIS) database. They included more than 3 million patients aged 18 years or older with a principal diagnosis of AF, then compared patients with PEM (n=602,691; mean age = 75 years) to patients who did not have concurrent PEM.
The analysis revealed that patients with PEM had an increased risk of mortality (odds ratio [OR], 2.275; 95% CI, 2.191–2.362; P<0.001). This was particularly true for Hispanic patients (OR, 1.504; 95% CI, 1.396–1.622; P<0.001). Patients with PEM were also more likely to have:
- Cardioversion (OR, 1.5155; 95% CI, 1.414–1.623; P<0.001)
- Coronary artery disease (OR, 0.921; 95% CI, 0.897–0.946; P<0.001)
- Heart failure (OR, 1.034; 95% CI, 1.004–1.065; P<0.001)
- Longer length of stay (data not provided)
- Stroke (OR, 4.30; 95% CI, 3.800–4.869; P<0.001)
“Healthcare providers should be aware of the impact of PEM on AF patients,” the authors concluded. “Early identification and management of PEM in AF patients are crucial to improve outcomes and reduce the burden of morbidity and mortality. This underscores the importance of comprehensive nutritional assessment and intervention strategies as part of the management of AF patients, aimed at optimizing nutritional status and improving overall clinical outcomes.”
Reference
Kavarthapu A, Kamani P, Saith S,et al. Prognostic impact of protein energy malnutrition in patients with atrial fibrillation: a nationwide inpatient study (2019). Abstract #A834. Presented at the CHEST Annual Meeting; October 6-9, 2024; Boston, Massachusetts.
