Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure
Background Dietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in pa...
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| Format: | Article |
| Language: | English |
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Wiley
2018-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.007251 |
| _version_ | 1818288096608780288 |
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| author | Terry A. Lennie Christina Andreae Mary Kay Rayens Eun Kyeung Song Sandra B. Dunbar Susan J. Pressler Seongkum Heo JinShil Kim Debra K. Moser |
| author_facet | Terry A. Lennie Christina Andreae Mary Kay Rayens Eun Kyeung Song Sandra B. Dunbar Susan J. Pressler Seongkum Heo JinShil Kim Debra K. Moser |
| author_sort | Terry A. Lennie |
| collection | DOAJ |
| description | Background Dietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death. Methods and Results Four‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates. Conclusions This study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes. |
| first_indexed | 2024-12-13T01:50:57Z |
| format | Article |
| id | doaj.art-7f2e7745939246f1968f1325efdc0141 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T01:50:57Z |
| publishDate | 2018-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-7f2e7745939246f1968f1325efdc01412022-12-22T00:03:30ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-09-0171710.1161/JAHA.117.007251Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart FailureTerry A. Lennie0Christina Andreae1Mary Kay Rayens2Eun Kyeung Song3Sandra B. Dunbar4Susan J. Pressler5Seongkum Heo6JinShil Kim7Debra K. Moser8College of Nursing University of Kentucky Lexington KYDivision of Nursing Science Department of Medical and Health Sciences Linköping University Linköping SwedenCollege of Nursing University of Kentucky Lexington KYDepartment of Nursing College of Medicine University of Ulsan KoreaEmory University Atlanta GAIndiana University Indianapolis INCollege of Nursing University of Arkansas for Medical Sciences Little Rock ARGachon University College of Nursing Incheon KoreaCollege of Nursing University of Kentucky Lexington KYBackground Dietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death. Methods and Results Four‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems for Research. Micronutrient deficiencies were determined according to methods recommended by the Institute of Medicine. Patients were followed for 1 year to collect data on all‐cause hospitalization or death. Patients were divided according to number of dietary micronutrient deficiencies at a cut point of ≥7 for the high deficiency category versus <7 for the no to moderate deficiency category. In the full sample, 29.8% of patients experienced hospitalization or death during the year, including 44.3% in the high‐deficiency group and 25.1% in the no/moderate group. The difference in survival distribution was significant (log rank, P=0.0065). In a Cox regression, micronutrient deficiency category predicted time to event with depression, NYHA classification, comorbidity burden, body mass index, calorie and sodium intake, and prescribed angiotensin‐converting enzyme inhibitors, diuretics, or β‐blockers included as covariates. Conclusions This study provides additional convincing evidence that diet quality of patients with heart failure plays an important role in heart failure outcomes.https://www.ahajournals.org/doi/10.1161/JAHA.117.007251dietheart failurenutritionrisk factorsurvival analysis |
| spellingShingle | Terry A. Lennie Christina Andreae Mary Kay Rayens Eun Kyeung Song Sandra B. Dunbar Susan J. Pressler Seongkum Heo JinShil Kim Debra K. Moser Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease diet heart failure nutrition risk factor survival analysis |
| title | Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure |
| title_full | Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure |
| title_fullStr | Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure |
| title_full_unstemmed | Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure |
| title_short | Micronutrient Deficiency Independently Predicts Time to Event in Patients With Heart Failure |
| title_sort | micronutrient deficiency independently predicts time to event in patients with heart failure |
| topic | diet heart failure nutrition risk factor survival analysis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007251 |
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