P1673Impact of objective nutritional indexes on one-year clinical outcomes after transcatheter aortic valve implanation

Background: Nutritional status has been shown to predict prognosis in some clinical settings. However, the association between nutritional status and clinical outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) has not been clarified. Purpose: We aimed to investigate the prognostic values of objective nutritional indexes in patients undergoing TAVI. Methods: We retrospectively analyzed 95 consecutive patients who underwent TAVI at our institution from December 2013 to February 2017. As objective nutritional indexes, controlling nutritional status (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) scores were calculated at baseline. Patients were divided into two groups according to their CONUT, PNI, or GNRI scores. The cut-off values were determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the composite of death or re-hospitalization due to heart failure within one year after TAVI. The secondary endpoint was one-year mortality. Results: Of 95 patients, high CONUT (≥4), low PNI (<44), or low GNRI (<103), all of which indicate worse nutritional status, were observed in 26 (27.4%), 33 (34.7%), and 55 (57.9%) patients, respectively. In the Kaplan-Meier analysis, patients with high CONUT, low PNI, or low GNRI scores showed higher incidence of the primary endpoint (46.2% vs. 15.9%, p=0.002; 42.4% vs. 14.5%, p=0.002; 32.7% vs. 12.5%, p=0.023, respectively). Moreover, high CONUT or low PNI scores were associated with higher risk of one-year mortality (26.9% vs. 2.9%, p<0.001; 18.2% vs. 4.8%, p=0.034, respectively). On Cox hazard analysis, higher CONUT, lower PNI, or lower GNRI predicted higher incidence of the primary endpoint independent of age and gender (p=0.003; p=0.004; p=0.041, respectively). Area under ROC curve for the primary endpoint was 0.710 in CONUT, 0.703 in PNI, and 0.632 in GNRI.