Vol.:(0123456789) 1 3 Clinical Research in Cardiology https://doi.org/10.1007/s00392-019-01497-9 ORIGINAL PAPER Nutritional status and risk of all‑cause mortality in patients undergoing transcatheter aortic valve replacement assessment using the geriatric nutritional risk index and the controlling nutritional status score Kyusup Lee 1  · Jung‑Min Ahn 2  · Do‑Yoon Kang 2  · Euihong Ko 2  · Osung Kwon 2  · Pil Hyung Lee 2  · Seung‑Whan Lee 2  · Dae‑Hee Kim 2  · Ho Jin Kim 3  · Joon Bum Kim 3  · Suk Jung Choo 3  · Duk‑Woo Park 2  · Seung‑Jung Park 2 Received: 28 March 2019 / Accepted: 20 May 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Background Nutritional status, a key marker of patient frailty, is an important prognostic factor after transcatheter aortic valve replacement (TAVR). Few investigations have evaluated the clinical usefulness of nutritional assessment tools for predicting the risk of mortality following TAVR. Methods A total of 412 patients with symptomatic severe AS who underwent TAVR between March 2010 and August 2017 were stratifed into subgroups by their Geriatric Nutritional Risk Index [GNRI, low ≤ 98 vs. high > 98 (better nutritional status)] and Controlling Nutritional Status (CONUT) score [low ≤ 3 vs. high ≥ 4; (poorer nutritional status)]. The primary study outcome was all-cause mortality at 1 year. Results Patients with low GNRI score showed a signifcantly higher 1-year mortality rate as compared to those with high GNRI score (13.0% vs. 3.2%, respectively; P = 0.001). Similarly, patients with high CONUT score had a signifcantly higher rate of 1-year mortality than those with low CONUT score (15.7% vs. 6.2%, respectively; P = 0.005). However, in mul- tivariable Cox proportional-hazards models, low GNRI was the only independent predictor of mortality (adjusted hazard ratio, 3.77; 95% confdence interval 1.54–9.20; P = 0.004). Overall, integration of GNRI into conventional risk models of STS score or logistic EuroSCORE resulted in improved predictive value for mortality measured by the net reclassifcation improvement and the integrated discrimination improvement. Conclusions In patients undergoing TAVR, low GNRI (but not high CONUT score) was independently associated with a higher risk of 1-year mortality. Further research is required to determine whether nutritional screening and management can improve clinical outcomes in patients undergoing TAVR. Kyusup Lee and Jung-Min Ahn contributed equally to this article. * Duk-Woo Park dwpark@amc.seoul.kr 1 Department of Cardiology, Daejeon St Mary’s Hospital, The Catholic University of Korea, Daejeon, South Korea 2 Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea 3 Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea