Individualized nutritional support reduced the risk for mortality and major cardiovascular events compared with standard hospital food among patients hospitalized with chronic heart failure (HF), according to a study published May 3 in the Journal of the American College of Cardiology.

Lara Hersberger, MD, et al., sought to assess the effect of nutritional support on mortality in patients hospitalized with chronic HF who are at nutritional risk. In the study, 645 patients with chronic HF were randomized to protocol-guided individualized nutritional support to reach energy, protein and micronutrient goals (intervention group) or standard hospital food (control group). All-cause mortality at 30 days was the primary endpoint.

Results showed mortality over 180 days increased with higher severity of malnutrition. By 30 days, 27 of the 321 intervention group patients (8.4%) died, compared with the 48 of the 324 control patients (14.8). Researchers also found that patients at high nutritional risk showed the most benefit from nutritional support; mortality effects remained significant at 180-day follow-up; and the intervention group had a lower risk for major cardiovascular events at 30 days.

"Our data suggest that among hospitalized patients with chronic [HF], malnutrition as assessed by the [Nutritional Risk Screening 2002] is an important risk factor for short- and long-term mortality and other clinical outcomes," write the authors of the study. "These data support malnutrition screening upon hospital admission followed by an individualized nutritional support strategy in this vulnerable patient population."

"This study adds another tile to the still-fragmentary mosaic picture of the patient with [HF] at nutritional risk who might benefit by additional nutritional support," adds Sheldon H. Gottlieb, MD, FACC, in an accompanying editorial comment . "'Good medical care' dictates that all hospitalized patients deserve to have a standardized nutritional assessment; the challenge remains: how to determine which patient with [HF] at nutritional risk will benefit by medical nutrition therapy."

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Nutrition Assessment, Micronutrients, Malnutrition, Nutritional Support, Nutrition Therapy, Heart Failure, Risk Factors, Reference Standards, Cardiovascular Diseases, Cardiology

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