Clinical implications of low estimated protein intake in patients with heart failure
Abstract Background A higher protein intake has been associated with a higher muscle mass and lower mortality rates in the general population, but data about protein intake and survival in patients with heart failure (HF) are lacking. Methods We studied the prevalence, predictors, and clinical outco...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-06-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12973 |
| _version_ | 1797204299961335808 |
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| author | Koen W. Streng Hans L. Hillege Jozine M. terMaaten Dirk J. vanVeldhuisen Kenneth Dickstein Leong L. Ng Nilesh J. Samani Marco Metra Piotr Ponikowski John G. Cleland Stefan D. Anker Simon P.R. Romaine Kevin Damman Peter van derMeer Chim C. Lang Adriaan A. Voors |
| author_facet | Koen W. Streng Hans L. Hillege Jozine M. terMaaten Dirk J. vanVeldhuisen Kenneth Dickstein Leong L. Ng Nilesh J. Samani Marco Metra Piotr Ponikowski John G. Cleland Stefan D. Anker Simon P.R. Romaine Kevin Damman Peter van derMeer Chim C. Lang Adriaan A. Voors |
| author_sort | Koen W. Streng |
| collection | DOAJ |
| description | Abstract Background A higher protein intake has been associated with a higher muscle mass and lower mortality rates in the general population, but data about protein intake and survival in patients with heart failure (HF) are lacking. Methods We studied the prevalence, predictors, and clinical outcome of estimated protein intake in 2516 patients from the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT‐CHF) index cohort. Protein intake was calculated in spot urine samples using a validated formula [13.9 + 0.907 * body mass index (BMI) (kg/m2) + 0.0305 * urinary urea nitrogen level (mg/dL)]. Association with mortality was assessed using multivariable Cox regression models. All findings were validated in an independent cohort. Results We included 2282 HF patients (mean age 68 ± 12 years and 27% female). Lower estimated protein intake in HF patients was associated with a lower BMI, but with more signs of congestion. Mortality rate in the lowest quartile was 32%, compared with 18% in the highest quartile (P < 0.001). In a multivariable model, lower estimated protein intake was associated with a higher risk of death compared with the highest quartile [hazard ratio (HR) 1.50; 95% confidence interval (CI) 1.03–2.18, P = 0.036 for the lowest quartile and HR 1.46; 95% CI 1.00–2.18, P = 0.049 for the second quartile]. Conclusions An estimated lower protein intake was associated with a lower BMI, but signs of congestion were more prevalent. A lower estimated protein intake was independently associated with a higher mortality risk. |
| first_indexed | 2024-04-12T13:14:51Z |
| format | Article |
| id | doaj.art-09abab01211642089de26c745d0136e0 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-24T08:33:02Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-09abab01211642089de26c745d0136e02024-04-16T18:10:50ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092022-06-011331762177010.1002/jcsm.12973Clinical implications of low estimated protein intake in patients with heart failureKoen W. Streng0Hans L. Hillege1Jozine M. terMaaten2Dirk J. vanVeldhuisen3Kenneth Dickstein4Leong L. Ng5Nilesh J. Samani6Marco Metra7Piotr Ponikowski8John G. Cleland9Stefan D. Anker10Simon P.R. Romaine11Kevin Damman12Peter van derMeer13Chim C. Lang14Adriaan A. Voors15Department of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsUniversity of Bergen Bergen NorwayDepartment of Cardiovascular Sciences University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital Leicester UKDepartment of Cardiovascular Sciences University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital Leicester UKInstitute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia Brescia ItalyDepartment of Heart Diseases Wroclaw Medical University Wroclaw PolandNational Heart and Lung Institute Imperial College London London UKDivision of Cardiology and Metabolism Charité Universitätsmedizin Berlin Berlin GermanyDepartment of Cardiovascular Sciences University of Leicester, Glenfield Hospital, and NIHR Leicester Biomedical Research Centre, Glenfield Hospital Leicester UKDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsDivision of Molecular and Clinical Medicine, School of Medicine University of Dundee Dundee UKDepartment of Cardiology University Medical Center Groningen, University of Groningen Groningen The NetherlandsAbstract Background A higher protein intake has been associated with a higher muscle mass and lower mortality rates in the general population, but data about protein intake and survival in patients with heart failure (HF) are lacking. Methods We studied the prevalence, predictors, and clinical outcome of estimated protein intake in 2516 patients from the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT‐CHF) index cohort. Protein intake was calculated in spot urine samples using a validated formula [13.9 + 0.907 * body mass index (BMI) (kg/m2) + 0.0305 * urinary urea nitrogen level (mg/dL)]. Association with mortality was assessed using multivariable Cox regression models. All findings were validated in an independent cohort. Results We included 2282 HF patients (mean age 68 ± 12 years and 27% female). Lower estimated protein intake in HF patients was associated with a lower BMI, but with more signs of congestion. Mortality rate in the lowest quartile was 32%, compared with 18% in the highest quartile (P < 0.001). In a multivariable model, lower estimated protein intake was associated with a higher risk of death compared with the highest quartile [hazard ratio (HR) 1.50; 95% confidence interval (CI) 1.03–2.18, P = 0.036 for the lowest quartile and HR 1.46; 95% CI 1.00–2.18, P = 0.049 for the second quartile]. Conclusions An estimated lower protein intake was associated with a lower BMI, but signs of congestion were more prevalent. A lower estimated protein intake was independently associated with a higher mortality risk.https://doi.org/10.1002/jcsm.12973Heart failureObesityBody mass indexProteinMortality |
| spellingShingle | Koen W. Streng Hans L. Hillege Jozine M. terMaaten Dirk J. vanVeldhuisen Kenneth Dickstein Leong L. Ng Nilesh J. Samani Marco Metra Piotr Ponikowski John G. Cleland Stefan D. Anker Simon P.R. Romaine Kevin Damman Peter van derMeer Chim C. Lang Adriaan A. Voors Clinical implications of low estimated protein intake in patients with heart failure Journal of Cachexia, Sarcopenia and Muscle Heart failure Obesity Body mass index Protein Mortality |
| title | Clinical implications of low estimated protein intake in patients with heart failure |
| title_full | Clinical implications of low estimated protein intake in patients with heart failure |
| title_fullStr | Clinical implications of low estimated protein intake in patients with heart failure |
| title_full_unstemmed | Clinical implications of low estimated protein intake in patients with heart failure |
| title_short | Clinical implications of low estimated protein intake in patients with heart failure |
| title_sort | clinical implications of low estimated protein intake in patients with heart failure |
| topic | Heart failure Obesity Body mass index Protein Mortality |
| url | https://doi.org/10.1002/jcsm.12973 |
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