Prognostic Impact of Simple Nutrition Index on the Long-Term Mortality in Acute Decompensated Heart Failure Patients with and Without Reduced Left Ventricular Ejection Fraction

Background: The novel nutrition index; triglyceride (TG) х total cholesterol (TC) х body weight (BW) index (TCBI) has been reported to be an easy and useful predictor for patients with coronary artery disease. However, there is no information available on the prognostic role of TCBI in the patients admitted for acute decompensated heart failure (ADHF), relating to left ventricular ejection fraction (LVEF). Methods and Results: We studied 605 patients admitted for ADHF in our prospective cohort study (HFrEF[LVEF<45%] n=259 and HFpEF[LVEF≥45%]:n=311). Echocardiography and venous blood sampling including TG, TC were performed just before discharge. TCBI was calculated by the formula; TG х TC х BW / 1000 at discharge. The endpoint of this study is all-cause death. During a follow up period of 2.8±1.4years, 171 patients died (79 patients in HFrEF and 92 patients in HFpEF). TCBI was significantly associated with all-cause death in patients with HFrEF (p=0.004) and HFpEF (p=0.0001) at univariate Cox analysis. All cause-death was significantly frequently observed in patients with than those without lower TCBI (<861.7=medcan value) in HFrEF (23% vs 38%, p=0.003) and HFpEF (20% vs 39%, p=0.00006). After adjustment for major confounders, TCBI remained a significant independent predictor for the total mortality in patients with HFpEF (adjusted hazard ratio: 1.88 [95%CI 1.18-3.00], p=0.008), while TCBI showed no independent association with the total mortality in HFrEF patients (adjusted hazard ratio: 1.15 [95%CI 0.71-1.85], p=0.58). Conclusion: TCBI at the discharge, a simple and novel nutrition index, provides a prognostic value for the prediction of total mortality in ADHF patients with HFrEF and HFpEF, although the prognostic significance of TCBI in patients with HFpEF was weakened by adjustment for relevant covariates.