Malnutrition in Hospitalized Heart Failure Patients with Reduced Ejection Fraction: Potential Association with Allocation of Guideline-Directed Medical Therapies

Background: Malnutrition is common in patients with heart failure with reduced ejection fraction (HFrEF) and may influence the long-term prognosis and allocation of guideline-directed medical therapy (GDMT).Methods and Results: We reviewed 1,231 consecutive patient-level records from a multicenter Japanese registry of hospitalized HFrEF patients. Nutritional status was assessed using the geriatric nutritional risk index (GNRI). GDMTs were categorized based on the use of beta-blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists. The composite outcome of all-cause death and HF rehospitalization was assessed. The mean age was 72.0±14.2 years and 42.6% patients were malnourished (GNRIConclusion: Malnutrition assessed by GNRI score predicts long-term adverse outcomes among hospitalized HFrEF patients. However, its prognosis may be modified with GDMT.