Heart failure & cardiomyopathies
Associations Between In-Hospital Daily Protein Intake and Adverse Clinical Outcomes in Older Patients with Heart Failure
Authors' conclusion
Lower DPI during hospitalization is associated with an increased risk of mortality and HF readmission independent of non-proteogenic energy intake, and the possible optimal DPI for predicting adverse clinical outcomes is >1.12 g/kg IBW/day in older patients with HF.
Study context
- Population
- Patients with heart failure (HF) aged ≥65 years (mean age 78.6 ± 7.5 years; 50% women)
- Participants
- 405 patients
- Exposure
- Lowest vs higher quartiles of in-hospital daily protein intake
- Outcome
- Composite of:
- All-cause mortality
- HF-related readmission
- Follow-up
- Within 2 years post-discharge
Methodological detailssingle-centre, daily protein intake (DPI) estimated from consumption over 3 consecutive days before discharge, normalized to ideal body weight
- Single-centre
- DPI estimated from consumption over 3 consecutive days before discharge, normalized to ideal body weight
Main finding
As reported in the abstract
mean follow-up 1.49 ± 0.74 years
Hazard ratio (95% CI)P value
Lowest DPI quartilevs Highest DPI quartilemultivariate Cox, adjusted for established prognostic markers and non-proteogenic energy intake
2.03(1.08–3.82)
P = 0.03Per SD (0.26 g/kg IBW/day) decrease in DPIlinear association (P for nonlinearity = 0.90)
1.32(1.10–1.71)
P = 0.04- Lower composite event-free rate in lowest DPI quartile vs upper quartiles (Kaplan-Meier, log-rank)
- P = 0.02
Observational data: associations, not effects.
Further findings
Effect of DPI by cystatin C-based eGFR (subgroup)
- Significant heterogeneity; possible disadvantage of lower DPI with cystatin C-based eGFR <30 mL/min/1.73 m²
DPI cutoff for predicting composite events (Youden index)
- Cutoff DPI
- 1.12 g/kg IBW/day
- Continuous net reclassification improvement adding DPI < 1.12 g/kg IBW/day to baseline model
- 0.294 (95% CI 0.072-0.516; P = 0.01)
Original publication
Associations Between In-Hospital Daily Protein Intake and Adverse Clinical Outcomes in Older Patients with Heart Failure. ESC Heart Fail. Published 5 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →