Malnutrition a risk factor for CV events among ACS patients with sleep apnoea

For patients with acute coronary syndrome (ACS), malnutrition appears to contribute to an increased risk of cardiovascular (CV) events, particularly for those with coexisting obstructive sleep apnoea (OSA), according to a study.

Researchers conducted a subanalysis of the OSA‐ACS project, which included 1,756 patients with ACS who underwent portable sleep monitoring. OSA was defined as an apnoea hypopnea index ≥15 events/h. Nutritional status was evaluated using the Controlling Nutritional Status score, the Nutritional Risk Index, and the Naples Prognostic Score.

OSA was identified in 53 percent of patients, while the prevalence of malnutrition varied by assessment index. The percentage of patients with malnutrition was 47.4 percent according to Controlling Nutritional Status score, 23 percent according to Nutritional Risk Index, and 87.8 percent according to Naples Prognostic Score.

Over a median follow-up of 2.9 years, malnutrition was associated with between a 1.6- to 2.7-fold increase in the risk of major adverse cardiovascular and cerebrovascular events among patients with OSA. The corresponding adjusted hazard ratios were 2.707 (95 percent confidence interval [CI], 1.128–6.494) among those with moderate‐to‐severe malnutrition based on Controlling Nutritional Status score, 1.647 (95 percent CI, 1.073–2.528) among those with moderate‐to‐severe malnutrition based on Nutritional Risk Index, and 1.962 (95 percent CI, 1.069–3.601) among those with moderate‐to‐severe malnutrition based on Naples Prognostic Score.

A linear dose–response relationship between the severity of malnutrition and the risk of major adverse cardiovascular and cerebrovascular events was observed among patients with OSA.

Malnutrition was not associated with CV risk among ACS patients without OSA.

The findings highlight the importance of proactive nutritional screening to identify ACS patients with OSA at high CV risk.