Heart failure & cardiomyopathies

Controlling Nutritional Status score as a predictor of ventricular arrhythmias in patients with advanced heart failure

ESC Heart FailPublished retrospective single-centre cohort study

Main finding · Composite of ventricular arrhythmias and all-cause mortalityResult — go to the resultAdjusted hazard ratio 2.33 95% CI 1.30–4.20

Authors' conclusion

CONUT-defined malnutrition was a strong independent predictor of ventricular arrhythmias and all-cause mortality in CRT recipients. Nutritional assessment may enhance risk stratification in patients with advanced HF undergoing CRT.

Study context

Population
Advanced heart failure (HF) patients receiving cardiac resynchronization therapy (CRT) between March 2004 and February 2023mean age 70.9 ± 9.5 years, 67.1% male
Participants
167 patients
Exposure
Malnutrition (CONUT score and Geriatric Nutritional Risk Index (GNRI)) as predictor of ventricular arrhythmias and all-cause mortality
  • CONUT-defined malnutritionn = 26
  • GNRI-defined malnutritionn = 37
Outcome
Composite of:
  • Ventricular arrhythmias
  • All-cause mortality
Follow-up
Median 1536 days (IQR: 844-1825 days)

Main finding

As reported in the abstract

Adjusted hazard ratio

2.33

95% CI 1.30–4.20

P < 0.01

CONUT-defined malnutrition
adjusted HR 2.33 (95% CI 1.30–4.20); P < 0.01
Higher event rates with CONUT-defined malnutrition, Kaplan-Meier log-rank
P = 0.0003
GNRI-defined malnutrition weak trend, log-rank
P = 0.06

Observational data: associations, not effects.

Further findings

Agreement between CONUT and GNRI malnutrition · moderate agreement

Agreement between CONUT and GNRI malnutrition — κ
0.44

All-cause mortality

CONUT
P = 0.0001
GNRI
P = 0.01

Ventricular arrhythmias

CONUT
P = 0.01
GNRI
P = 0.38

Discrimination: adding CONUT score to base model

Concordance index
0.695 to 0.713
P
P = 0.008

Time-dependent ROC for CONUT-defined malnutrition · 1825 days

AUC
0.80 (95% CI: 0.67-0.94)

Original publication

Controlling Nutritional Status score as a predictor of ventricular arrhythmias in patients with advanced heart failure. ESC Heart Fail. Published 26 February 2026. doi:10.1093/eschf/xvag037

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