Researchers studied 1,515 heart attack patients who received a procedure to open blocked arteries. They discovered that a simple nutritional health score could predict which patients were more likely to have serious heart problems after treatment. Patients with lower nutritional scores were more likely to need hospital care again, have another heart attack, or face other heart complications within about 3 years. This finding suggests doctors could use this easy-to-calculate score to identify patients who need extra care and support after their heart procedure.

The Quick Take

  • What they studied: Whether a simple nutritional health score could predict which heart attack patients would have serious problems after receiving a procedure to open blocked heart arteries
  • Who participated: 1,515 patients who had a heart attack and underwent a procedure called percutaneous coronary intervention (PCI) to restore blood flow to their heart
  • Key finding: Patients with lower nutritional health scores were significantly more likely to experience serious heart problems, including death, another heart attack, or needing to return to the hospital within about 3 years of their procedure
  • What it means for you: If you’ve had a heart attack and received this procedure, your doctor might use this nutritional score to determine if you need extra monitoring or support. However, this is one tool among many—talk to your doctor about your individual risk factors.

The Research Details

This was a prospective cohort study, which means researchers followed a group of patients forward in time to see what happened to them. They enrolled 1,515 patients who had a heart attack and received a procedure called PCI (a catheter-based intervention that opens blocked arteries). Researchers calculated each patient’s Geriatric Nutritional Risk Index (GNRI)—a simple score based on body weight and height measurements that reflects overall nutritional health. They then tracked these patients for about 1,000 days (roughly 3 years) to see who experienced serious heart problems.

The researchers used several statistical methods to analyze the data. They created graphs showing survival rates over time, compared outcomes between patients with high versus low GNRI scores, and used mathematical models to determine if the GNRI score independently predicted problems even after accounting for other risk factors like age and existing health conditions.

This research approach is important because it follows real patients over a long period, which helps show whether the nutritional score actually predicts what happens in the real world. By using multiple statistical methods and adjusting for other factors that might affect outcomes, the researchers could determine whether the GNRI score itself is truly predictive or whether other factors were responsible for the differences.

This study has several strengths: it included a large number of patients (1,515), followed them for a substantial period (about 3 years), and used rigorous statistical methods. The researchers adjusted their analysis for other factors that could influence outcomes. However, this was an observational study, meaning researchers watched what happened naturally rather than randomly assigning patients to different treatments, so we cannot be completely certain about cause-and-effect relationships. The study was published in a peer-reviewed journal, meaning other experts reviewed the work before publication.

What the Results Show

The researchers found that patients with lower GNRI scores (below 110.78) had significantly worse outcomes than those with higher scores. Specifically, patients with lower nutritional scores were more likely to experience major adverse cardiovascular events—a term that includes death from any cause, severe heart failure requiring hospitalization, need for additional heart procedures, another heart attack, or blood clots in stents (the small tubes placed to keep arteries open).

When researchers tracked patients over time using survival curves, they found that those with lower GNRI scores had noticeably lower survival rates. The difference became more apparent as time went on, with the gap widening over the 3-year follow-up period. Statistical tests confirmed these differences were not due to chance.

The nutritional score remained predictive even after researchers accounted for other important factors like age, existing diseases, and other risk factors. This suggests the GNRI score provides additional useful information beyond what doctors already know about a patient’s risk.

Beyond the main findings, the study revealed that lower GNRI scores were particularly strong at predicting two specific outcomes: patients needing to return to the hospital for heart-related reasons and death from heart problems. The researchers also used a special statistical method called competing risk analysis, which accounts for the fact that patients might experience different types of events (like death versus rehospitalization). This analysis confirmed that the nutritional score predicted both outcomes independently.

The GNRI score has been studied in other diseases and has shown promise for predicting outcomes. This study extends that research by showing the score may also be useful in heart attack patients who receive PCI. The finding that nutritional status predicts heart outcomes aligns with previous research suggesting that malnutrition or poor nutritional status is linked to worse health outcomes in heart disease. However, this appears to be one of the first studies specifically examining the GNRI in this patient population.

Several limitations should be considered: First, this was an observational study, so we cannot prove that poor nutrition directly causes worse outcomes—only that they are associated. Second, the study was conducted at specific hospitals, so results might differ in other populations or healthcare settings. Third, the GNRI is based only on weight and height; it doesn’t capture all aspects of nutritional status or diet quality. Fourth, the researchers did not have detailed information about patients’ diets or nutritional interventions they may have received. Finally, the study’s ability to predict outcomes (measured by the area under the curve of 0.603) was moderate, meaning the GNRI score alone cannot perfectly predict which patients will have problems.

The Bottom Line

Based on this research, doctors may consider calculating the GNRI score for heart attack patients undergoing PCI to help identify those at higher risk for complications. Patients with lower scores might benefit from extra monitoring, nutritional counseling, and more frequent follow-up appointments. However, this score should be used alongside other risk assessment tools, not as a replacement for them. The evidence is moderate in strength—the score shows promise but is not a perfect predictor.

This research is most relevant to: (1) patients who have had a heart attack and received PCI, (2) cardiologists and heart specialists who care for these patients, and (3) healthcare systems looking for tools to identify high-risk patients. If you have had a heart attack, ask your doctor whether your nutritional status has been assessed and whether nutritional support might be beneficial for your recovery. This research is less directly relevant to people without heart disease, though it reinforces the general importance of good nutrition for overall health.

The study followed patients for about 3 years, so serious complications typically developed within this timeframe. If you’re a patient with a low nutritional score, improvements in nutrition might take weeks to months to show benefits, but the protective effects would likely develop gradually over time. Don’t expect immediate results, but consistent attention to nutrition could help reduce your long-term risk.

Want to Apply This Research?

  • For heart attack patients, track your GNRI score quarterly by recording your weight and height, then calculating the score with your healthcare provider. Also track related metrics: daily protein intake (grams), number of hospital visits, and any heart-related symptoms or medication changes.
  • Users can set a goal to improve their GNRI score by focusing on adequate protein intake and maintaining a healthy weight. The app could provide meal suggestions emphasizing protein-rich foods, track daily food intake, and send reminders for regular weigh-ins. Users could also log follow-up appointments and share their nutritional progress with their healthcare provider.
  • Establish a long-term tracking system that includes: (1) monthly weight monitoring, (2) quarterly GNRI score calculation, (3) tracking of any hospitalizations or cardiac events, (4) medication adherence monitoring, and (5) regular check-ins with your cardiologist. The app should alert users if their weight drops significantly or if their GNRI score declines, prompting them to contact their doctor.

This research suggests an association between nutritional status and heart attack outcomes, but it does not prove that improving nutrition will prevent complications. This information is for educational purposes and should not replace professional medical advice. If you have had a heart attack or are at risk for heart disease, consult with your cardiologist or healthcare provider before making any changes to your diet, medications, or treatment plan. Your doctor can assess your individual risk factors and recommend personalized strategies for your recovery and long-term health.