Nutritional markers and prognosis in cardiac cachexia

• Type: Article in International Scientific Journal
• Date: 2009

Authors

Araújo JP (Author) FMUP

Journal

Title: International Journal of Cardiology

ISSN: 0167-5273

Publisher: Elsevier

Indexing

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences > Medical sciences > Medicine > Cardiology

Other information

Abstract (EN): BACKGROUND: Cachexia frequently complicates chronic heart failure (CHF) and predicts an ominous prognosis. Hormonal and inflammatory environment differ between cachectic and non-cachectic patients. Nutritional markers of cardiac cachexia and prognostic predictors in this context are not completely understood. OBJECTIVES: To study biochemical markers of nutritional status in cardiac cachexia and to investigate variables associated with worse prognosis. METHODS: A total of 94 ambulatory patients - 38 cachectics and 56 non-cachectics - were recruited. Cardiac cachexia was defined as a weight loss of >/=7.5%. An anthropometric evaluation was performed in all patients and blood was collected for several laboratory determinations: haemoglobin, lymphocytes, albumin, transferrin, pre-albumin, cholesterol and triglycerides. Patients were included in a prospective cohort study. RESULTS: Cachectics had lower albumin and pre-albumin levels. They also had lower haemoglobin, lymphocytes and triglycerides. Levels of high-sensitivity C-reactive protein, and catabolic hormones were higher in the cachectic group. Low pre-albumin was the only nutritional marker independently associated with cardiac cachexia. (OR=1.08, CI: 1.01-1.17). During a follow-up of 16.2+/-5.2months, 15 (39.4%) cachectic patients and 6 (10.7%) non-cachectics died. In the cachectic group, lower cholesterol was independently associated with worse outcome (HR=1.32, CI: 1.11-1.57). CONCLUSIONS: Pre-albumin seems to be the best laboratory marker of undernutrition in CHF. Low cholesterol independently associates with worse outcome in cardiac cachexia.

Language: Portuguese

Type (Professor's evaluation): Scientific