Table 1.
Prognostic Outcomes Following Acute Coronary Syndrome Across the Entire Follow-Up Duration, Pooled and With Stratification by Subgroups
| Studies | With Malnutrition |
Without Malnutrition |
Comparison of Patients With Malnutrition Against Without Malnutrition |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Proportion (95% CI) | I2 | P Value | Proportion (95% CI) | I2 | P Value | OR (95% CI) | I2 | P Value | ||
| All-cause mortality | ||||||||||
| Overall | 25 | 20.59% (14.95%-27.67%) | 96.0% | 5.41% (3.44%-8.39%) | 97.0% | 4.51 (3.33-6.12) | 87.0% | <0.001 | ||
| Nutritional assessment tool | 0.717 | 0.181 | 0.499 | |||||||
| CONUT | 5 | 15.14% (5.43%-35.66%) | 96.4% | 2.18% (0.52%-8.61%) | 94.5% | 7.80 (2.17-28.07) | 87.3% | 0.011 | ||
| GNRI | 10 | 21.33% (10.47%-38.61%) | 96.6% | 5.90% (2.34%-8.61%) | 95.8% | 4.30 (2.78-6.66) | 82.2% | <0.001 | ||
| PNI | 5 | 24.38% (11.72%-43.90%) | 97.0% | 6.75% (3.11%-14.02%) | 97.9% | 4.67 (2.38-9.17) | 86.1% | 0.023 | ||
| Others | 5 | 21.66% (13.65%-32.58%) | 89.2% | 7.79% (2.97%-18.94%) | 98.4% | 3.29 (1.31-8.31) | 91.6% | 0.003 | ||
| Mean age, y | 0.166 | 0.002 | 0.052 | |||||||
| <65 | 7 | 16.38% (7.51%-32.11%) | 95.8% | 2.89% (1.41%-5.86%) | 91.0% | 6.93 (3.39-14.15) | 83.8% | <0.001 | ||
| ≥65 | 17 | 25.28% (19.39%-32.11%) | 94.8% | 8.37% (5.58%-12.37%) | 96.4% | 3.67 (2.69-5.01) | 83.5% | <0.001 | ||
| Type of ACS | 0.293 | 0.099 | 0.132 | |||||||
| ACS | 15 | 22.82% (16.63%-30.46%) | 96.0% | 7.47% (4.42%-12.36%) | 97.4% | 3.61 (2.58-5.05) | 85.7% | <0.001 | ||
| STEMI | 6 | 23.51% (8.86%-49.30%) | 95.7% | 4.34% (1.58%-11.33%) | 93.2% | 7.21 (3.05-17.04) | 84.8% | 0.002 | ||
| NSTE-ACS | 4 | 10.70% (2.00%-41.24%) | 96.0% | 2.12% (0.32%-12.93%) | 82.9% | 4.99 (2.38-10.46) | 29.6% | 0.006 | ||
| Duration of follow-up | 0.986 | 0.742 | 0.560 | |||||||
| 2 y or less | 12 | 20.40% (16.19%-25.37%) | 85.5% | 4.96% (3.04%-7.97%) | 97.4% | 4.93 (2.91-8.37) | 87.8% | <0.001 | ||
| More than 2 y | 13 | 20.50% (10.88%-35.28%) | 97.4% | 5.73% (2.47%-12.72%) | 96.5% | 4.16 (2.88-8.37) | 86.9% | <0.001 | ||
| Ethnicity | 0.036 | 0.008 | 0.245 | |||||||
| Predominantly Asiana | 19 | 18.19% (12.04%-26.55%) | 96.3% | 3.23% (2.46%-7.16%) | 93.1% | 5.03 (3.54-7.16) | 80.5% | <0.001 | ||
| Predominantly White | 6 | 29.51% (20.31%-40.75%) | 96.2% | 11.10% (5.63%-20.72%) | 97.0% | 3.37 (1.68-6.74) | 92.6% | 0.006 | ||
| Prospective/retrospective | 0.158 | 0.286 | 0.636 | |||||||
| Prospective | 8 | 15.89% (10.22%-23.86%) | 90.5% | 4.11% (2.19%-7.60%) | 87.9% | 4.10 (2.92-5.75) | 45.4% | <0.001 | ||
| Retrospective | 17 | 23.11% (15.03%-33.82%) | 96.0% | 6.20% (3.40%-11.02%) | 97.1% | 4.62 (2.99-7.13) | 90.7% | <0.001 | ||
| Income group | 0.317 | 0.043 | 0.058 | |||||||
| High | 12 | 23.79% (17.33%-31.74%) | 95.7% | 8.21% (4.61%-14.21%) | 97.0% | 3.50 (2.25-5.43) | 87.6% | <0.001 | ||
| Upper middle | 13 | 17.81% (9.80%-30.18%) | 96.3% | 3.71% (1.94%-7.00%) | 92.3% | 5.84 (3.93-8.67) | 78.1% | <0.001 | ||
| Other outcomes | ||||||||||
| Cardiac mortality | 7 | 11.37% (4.35%-26.59%) | 95.9% | 3.47% (1.79%-6.64%) | 87.0% | 3.74 (1.77-7.88) | 78.6% | 0.005 | ||
| In-hospital mortality | 8 | 16.40% (10.85%-24.02%) | 95.8% | 3.24% (2.09%-4.99%) | 84.1% | 5.83 (3.29-10.33) | 89.6% | <0.001 | ||
| MACE | 11 | 27.48% (19.01%-37.96%) | 97.8% | 11.89% (7.86%-17.60%) | 98.6% | 2.74 (2.14-3.51) | 86.6% | <0.001 | ||
| Cerebrovascular accident | 5 | 3.43% (1.15%-9.72%) | 81.9% | 1.47% (0.64%-3.31%) | 70.5% | 3.42 (1.98-5.93) | 0.0% | 0.034 | ||
| Coronary revascularization | 8 | 16.35% (3.86%-48.74%) | 98.8% | 18.04% (3.87%-54.60%) | 99.4% | 0.98 (0.61-1.57) | 86.1% | 0.933 | ||
| Medications | ||||||||||
| Aspirin | 9 | 92.36% (73.69%-98.12%) | 97.7% | 93.78% (75.52%-98.66%) | 99.2% | 0.92 (0.70-1.21) | 33.6% | 0.510 | ||
| Beta-blockers | 12 | 70.96% (50.26%-85.52%) | 97.3% | 74.77% (55.47%-87.58%) | 98.8% | 0.78 (0.67-0.90) | 45.4% | 0.004 | ||
| ARB | 12 | 68.68% (49.99%-82.79%) | 98.4% | 69.79% (50.22%-84.10%) | 98.8% | 0.99 (0.83-1.17) | 69.2% | 0.853 | ||
| Statins | 13 | 89.38% (71.69%-96.55%) | 97.2% | 94.00% (74.28%-98.84%) | 99.3% | 0.71 (0.41-1.23) | 91.5% | 0.200 | ||
Bold values indicate P value of <0.05 and it is taken as statistical significance.
ACS = acute coronary syndrome; ARB = angiotensin receptor blocker; CABG = coronary artery bypass graft; CONUT = controlling nutritional status; GNRI = Geriatric Nutritional Risk Index; MACE = major adverse cardiovascular outcomes; NSTE-ACS = non-ST-segment elevation acute coronary syndrome; NSTEMI = non-ST-segment elevation myocardial infarction; PNI = Prognostic Nutrition Index; STEMI = ST-segment elevation myocardial infarction.
a
Predominantly Asian included all Asian ethnicities.