• Carolina Ortiz Cortés, Purificación Rey-Sánchez, Jose Javier Gómez Barrado, Ramón Bover Freire, Emilio Paredes-Galán, Julián F Calderón-García, Alberto Esteban-Fernández, and Sergio Rico-Martín.
• Cardiology Department, University Hospital Fundación de Alcorcón, Madrid, Spain. Electronic address: carol.ortizcortes@gmail.com.
• Med Clin (Barc). 2024 Sep 9.

Background And ObjectivesMalnutrition is common in patients with heart failure (HF) and is associated with poor prognosis. We evaluated the prognostic and clinical impact of a nutritional intervention in malnourished patients with chronic HF.MethodsA randomized controlled clinical trial was carried out in patients with chronic HF who were malnourished or at risk. Participants were randomized to receive an individualized nutritional intervention or conventional management. The primary endpoint was a composite of all-cause mortality or time-to-first HF hospitalizations at the 12-month follow-up. The secondary endpoints were changes in nutritional status and functional capacity.ResultsWe screened 225 patients, 86 of whom had some degree of malnutrition and were randomized. At 12 months, the primary outcome occurred in 10 patients (23.8%) in the intervention group and in 22 patients (50.0%) in the control group (HR=0.39; 95% CI, 0.19-0.83). This effect was mainly related to a lower risk of hospitalization for HF in the intervention group: 8 patients (19.0%) versus 18 patients (40.9%) in the control group (HR=0.39; 95% CI=0.17-0.89). We observed an improvement in nutritional status and functional capacity in the intervention group versus the control group.ConclusionsIn patients with chronic HF and some degree of malnutrition, individualized nutritional intervention may reduce the risk of all-cause mortality or HF hospitalisations and improve nutritional status and functional capacity. These results underline the need for further randomized controlled trials with this approach to confirm the potential prognostic benefit.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

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