Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair

Background: Transcatheter edge-to-edge repair (TEER) is used to treat patients with mitral regurgitation (MR). The Geriatric Nutritional Risk Index (GNRI) is a well-known nutritional marker that predicts mortality risk. Objectives: The objectives of this study were to elucidate the clinical associat...

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Main Authors: Kenichi Shibata, PT, Masanori Yamamoto, MD, Ai Kagase, MD, Takahiro Tokuda, MD, Hiroshi Tsunamoto, MD, Testuro Shimura, MD, Azusa Kurita, MD, Ryo Yamaguchi, MD, Mike Saji, MD, Masahiko Asami, MD, Yusuke Enta, MD, Masaki Nakashima, MD, Shinichi Shirai, MD, Masaki Izumo, MD, Shingo Mizuno, MD, Yusuke Watanabe, MD, Makoto Amaki, MD, Kazuhisa Kodama, MD, Junichi Yamaguchi, MD, Toru Naganuma, MD, Hiroki Bota, MD, Yohei Ohno, MD, Masahiro Yamawaki, MD, Daisuke Hachinohe, MD, Hiroshi Ueno, MD, Kazuki Mizutani, MD, Toshiaki Otsuka, MD, Shunsuke Kubo, MD, Kentaro Hayashida, MD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X25000481
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author Kenichi Shibata, PT
Masanori Yamamoto, MD
Ai Kagase, MD
Takahiro Tokuda, MD
Hiroshi Tsunamoto, MD
Testuro Shimura, MD
Azusa Kurita, MD
Ryo Yamaguchi, MD
Mike Saji, MD
Masahiko Asami, MD
Yusuke Enta, MD
Masaki Nakashima, MD
Shinichi Shirai, MD
Masaki Izumo, MD
Shingo Mizuno, MD
Yusuke Watanabe, MD
Makoto Amaki, MD
Kazuhisa Kodama, MD
Junichi Yamaguchi, MD
Toru Naganuma, MD
Hiroki Bota, MD
Yohei Ohno, MD
Masahiro Yamawaki, MD
Daisuke Hachinohe, MD
Hiroshi Ueno, MD
Kazuki Mizutani, MD
Toshiaki Otsuka, MD
Shunsuke Kubo, MD
Kentaro Hayashida, MD
author_facet Kenichi Shibata, PT
Masanori Yamamoto, MD
Ai Kagase, MD
Takahiro Tokuda, MD
Hiroshi Tsunamoto, MD
Testuro Shimura, MD
Azusa Kurita, MD
Ryo Yamaguchi, MD
Mike Saji, MD
Masahiko Asami, MD
Yusuke Enta, MD
Masaki Nakashima, MD
Shinichi Shirai, MD
Masaki Izumo, MD
Shingo Mizuno, MD
Yusuke Watanabe, MD
Makoto Amaki, MD
Kazuhisa Kodama, MD
Junichi Yamaguchi, MD
Toru Naganuma, MD
Hiroki Bota, MD
Yohei Ohno, MD
Masahiro Yamawaki, MD
Daisuke Hachinohe, MD
Hiroshi Ueno, MD
Kazuki Mizutani, MD
Toshiaki Otsuka, MD
Shunsuke Kubo, MD
Kentaro Hayashida, MD
author_sort Kenichi Shibata, PT
collection DOAJ
description Background: Transcatheter edge-to-edge repair (TEER) is used to treat patients with mitral regurgitation (MR). The Geriatric Nutritional Risk Index (GNRI) is a well-known nutritional marker that predicts mortality risk. Objectives: The objectives of this study were to elucidate the clinical association between the degree of GNRI and different etiologies of MR and to clarify the patient samples for whom GNRI is more relevant to clinical outcomes following TEER. Methods: Data from 3,554 patients with MR who underwent TEER were analyzed using a Japanese multicenter registry. The patients were classified into 4 groups: GNRI <82, GNRI 82 to 92, GNRI 92 to 98, and GNRI >98. Procedural and clinical outcomes were compared between GNRI groups. Short- and long-term all-cause mortality were explored using Cox regression analysis. Results: Among the 3,554 patients, the median GNRI was 92.3. The mean follow-up period was 586.8 ± 436.5 days; 806 patients died during the follow-up period. Thirty-day mortality occurred in 51 patients (1.4%), and the GNRI <82 group had the highest 30-day mortality rate. Kaplan–Meier curves showed significantly better prognoses for the entire cohort, functional MR, and degenerative MR across the 4 groups (P < 0.001). GNRI values, even after adjustment for multiple confounders, showed a stepwise increase in risk of death in the GNRI 92 to 98, GNRI 82 to 92, and GNRI <82 groups compared to GNRI >98 as the reference. Conclusions: Regardless of MR etiology, GNRI is a useful predictor of short- and long-term mortality in patients undergoing TEER. Although TEER is effective for MR patients in malnourished states, further studies focused on the value of identifying and addressing malnutrition in this population are needed.
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spelling doaj-art-891c8d66d9cd4dee862c257905c61fdb2025-08-20T03:11:15ZengElsevierJACC: Advances2772-963X2025-04-014410163110.1016/j.jacadv.2025.101631Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge RepairKenichi Shibata, PT0Masanori Yamamoto, MD1Ai Kagase, MD2Takahiro Tokuda, MD3Hiroshi Tsunamoto, MD4Testuro Shimura, MD5Azusa Kurita, MD6Ryo Yamaguchi, MD7Mike Saji, MD8Masahiko Asami, MD9Yusuke Enta, MD10Masaki Nakashima, MD11Shinichi Shirai, MD12Masaki Izumo, MD13Shingo Mizuno, MD14Yusuke Watanabe, MD15Makoto Amaki, MD16Kazuhisa Kodama, MD17Junichi Yamaguchi, MD18Toru Naganuma, MD19Hiroki Bota, MD20Yohei Ohno, MD21Masahiro Yamawaki, MD22Daisuke Hachinohe, MD23Hiroshi Ueno, MD24Kazuki Mizutani, MD25Toshiaki Otsuka, MD26Shunsuke Kubo, MD27Kentaro Hayashida, MD28Department of Rehabilitation, Nagoya Heart Center, Nagoya, Japan; Dr Kenichi Shibata, Department of Cardiology, Nagoya Heart Center, 1-1-14 Sunadabashi, Higashi-ku, Nagoya Aichi 461-0045, Japan.Department of Cardiology, Nagoya Heart Center, Nagoya, Japan; Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan; Address for correspondence: Dr Masanori Yamamoto, Department of Cardiology, Nagoya Heart Center, 1-1-14 Sunadabashi, Higashi-ku, Nagoya Aichi 461-0045, Japan.Department of Cardiology, Nagoya Heart Center, Nagoya, JapanDepartment of Cardiology, Nagoya Heart Center, Nagoya, JapanDepartment of Cardiology, Nagoya Heart Center, Nagoya, JapanDepartment of Cardiology, Gifu Heart Center, Gifu, JapanDepartment of Cardiology, Gifu Heart Center, Gifu, JapanDepartment of Cardiology, Toyohashi Heart Center, Toyohashi, JapanDepartment of Cardiology, Sakakibara Heart Institute, Fuchu, JapanDivision of Cardiology, Mitsui Memorial Hospital, Tokyo, JapanDepartment of Cardiology, Sendai Kosei Hospital, Sendai, JapanDepartment of Cardiology, Sendai Kosei Hospital, Sendai, JapanDivision of Cardiology, Kokura Memorial Hospital, Kitakyushu, JapanDivision of Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki, JapanDepartment of Cardiology, Shonan Kamakura General Hospital, Kanagawa, JapanDepartment of Cardiology, Teikyo University School of Medicine, Tokyo, JapanDepartment of Cardiology, National Cerebral and Cardiovascular Center, Suita, JapanDivision of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, JapanDepartment of Cardiology, Tokyo Woman’s Medical University, Tokyo, JapanDepartment of Cardiology, New Tokyo Hospital, Chiba, JapanDepartment of Cardiology, Sapporo Higashi Tokushukai Hospital, Sapporo, JapanDepartment of Cardiology, Tokai University School of Medicine, Isehara, JapanDepartment of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, JapanDepartment of Cardiology, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Sapporo, JapanSecond Department of Internal Medicine, Toyama University Hospital, Toyama, JapanDivision of Cardiology, Department of Medicine, Kinki University Faculty of Medicine, Osaka, JapanDepartment of Hygiene and Public Health, Nippon Medical School, Tokyo, JapanDepartment of Cardiology, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiology, Keio University School of Medicine, Tokyo, JapanBackground: Transcatheter edge-to-edge repair (TEER) is used to treat patients with mitral regurgitation (MR). The Geriatric Nutritional Risk Index (GNRI) is a well-known nutritional marker that predicts mortality risk. Objectives: The objectives of this study were to elucidate the clinical association between the degree of GNRI and different etiologies of MR and to clarify the patient samples for whom GNRI is more relevant to clinical outcomes following TEER. Methods: Data from 3,554 patients with MR who underwent TEER were analyzed using a Japanese multicenter registry. The patients were classified into 4 groups: GNRI <82, GNRI 82 to 92, GNRI 92 to 98, and GNRI >98. Procedural and clinical outcomes were compared between GNRI groups. Short- and long-term all-cause mortality were explored using Cox regression analysis. Results: Among the 3,554 patients, the median GNRI was 92.3. The mean follow-up period was 586.8 ± 436.5 days; 806 patients died during the follow-up period. Thirty-day mortality occurred in 51 patients (1.4%), and the GNRI <82 group had the highest 30-day mortality rate. Kaplan–Meier curves showed significantly better prognoses for the entire cohort, functional MR, and degenerative MR across the 4 groups (P < 0.001). GNRI values, even after adjustment for multiple confounders, showed a stepwise increase in risk of death in the GNRI 92 to 98, GNRI 82 to 92, and GNRI <82 groups compared to GNRI >98 as the reference. Conclusions: Regardless of MR etiology, GNRI is a useful predictor of short- and long-term mortality in patients undergoing TEER. Although TEER is effective for MR patients in malnourished states, further studies focused on the value of identifying and addressing malnutrition in this population are needed.http://www.sciencedirect.com/science/article/pii/S2772963X25000481Geriatric Nutritional Risk Indexmitral regurgitationpredictorrisk stratificationtranscatheter edge-to-edge repair
spellingShingle Kenichi Shibata, PT
Masanori Yamamoto, MD
Ai Kagase, MD
Takahiro Tokuda, MD
Hiroshi Tsunamoto, MD
Testuro Shimura, MD
Azusa Kurita, MD
Ryo Yamaguchi, MD
Mike Saji, MD
Masahiko Asami, MD
Yusuke Enta, MD
Masaki Nakashima, MD
Shinichi Shirai, MD
Masaki Izumo, MD
Shingo Mizuno, MD
Yusuke Watanabe, MD
Makoto Amaki, MD
Kazuhisa Kodama, MD
Junichi Yamaguchi, MD
Toru Naganuma, MD
Hiroki Bota, MD
Yohei Ohno, MD
Masahiro Yamawaki, MD
Daisuke Hachinohe, MD
Hiroshi Ueno, MD
Kazuki Mizutani, MD
Toshiaki Otsuka, MD
Shunsuke Kubo, MD
Kentaro Hayashida, MD
Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
JACC: Advances
Geriatric Nutritional Risk Index
mitral regurgitation
predictor
risk stratification
transcatheter edge-to-edge repair
title Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
title_full Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
title_fullStr Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
title_full_unstemmed Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
title_short Geriatric Nutritional Risk Index Assessment in Patients Undergoing Transcatheter Edge-to-Edge Repair
title_sort geriatric nutritional risk index assessment in patients undergoing transcatheter edge to edge repair
topic Geriatric Nutritional Risk Index
mitral regurgitation
predictor
risk stratification
transcatheter edge-to-edge repair
url http://www.sciencedirect.com/science/article/pii/S2772963X25000481
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