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Article

Nutritional Indices Are Associated with Mortality in the Elderly Patients Undergoing Left Atrial Appendage Occlusion: A Comparative Study of CONUT, GNRI, and PNI

by
Ugur Karagoz
1,*,
Enise Nur Ozlem Tiryaki
2,
Enis Behcet Agirdici
3,
Berke Ege
1,
Muhammet Mucahit Tiryaki
4,
Emre Ozdemir
1 and
Sadık Volkan Emren
1
1
Department of Cardiology, Faculty of Medicine, Atatürk Research and Training Hospital, Katip Çelebi University, Izmir 35620, Türkiye
2
Department of Neurology, Mus State Hospital, Mus 49200, Türkiye
3
Department of Cardiology, Izmir City Hospital, Izmir 35540, Türkiye
4
Department of Cardiology, Mus State Hospital, Mus 49200, Türkiye
*
Author to whom correspondence should be addressed.
J. Cardiovasc. Dev. Dis. 2026, 13(5), 177; https://doi.org/10.3390/jcdd13050177
Submission received: 8 March 2026 / Revised: 18 April 2026 / Accepted: 21 April 2026 / Published: 24 April 2026
(This article belongs to the Special Issue Multidisciplinary Decision-Making and Patient Selection in Complex Structural Heart Interventions)
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Abstract

Background: We investigated the prognostic value of nutritional indices in patients with atrial fibrillation (AF) undergoing percutaneous left atrial appendage occlusion (LAAO). Methods: This two-center retrospective study enrolled 151 patients (median age 75, IQR: 69–80) undergoing LAAO. The Controlling Nutritional Status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) were calculated preoperatively. Endpoints included all-cause mortality (primary), postoperative bleeding, and stroke. Associations with mortality were analyzed using multivariable Cox regression models. Results: Over a median follow-up of 8 months (IQR: 5–13), 28 patients (18.5%) died. In multivariable analyses (adjusted for age, sex, diabetes, and chronic kidney disease), each 1-point increase in the CONUT score was associated with a higher risk of all-cause mortality (HR 1.196, 95% CI 1.029–1.390; p = 0.020), whereas higher GNRI values were associated with a lower mortality risk (HR 0.956, 95% CI 0.915–0.998; p = 0.042). In contrast, PNI was not associated with mortality (p = 0.993). Nutritional indices did not significantly predict secondary outcomes like bleeding or stroke. Conclusions: These findings suggest that malnutrition is strongly and independently associated with mortality in high-risk AF patients receiving LAAO. The CONUT score demonstrates the most robust association in this population, highlighting the importance of metabolic reserves.
Keywords: malnutrition; controlling nutritional status; geriatric nutritional risk index; prognostic nutritional index; elderly malnutrition; controlling nutritional status; geriatric nutritional risk index; prognostic nutritional index; elderly
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MDPI and ACS Style

Karagoz, U.; Tiryaki, E.N.O.; Agirdici, E.B.; Ege, B.; Tiryaki, M.M.; Ozdemir, E.; Emren, S.V. Nutritional Indices Are Associated with Mortality in the Elderly Patients Undergoing Left Atrial Appendage Occlusion: A Comparative Study of CONUT, GNRI, and PNI. J. Cardiovasc. Dev. Dis. 2026, 13, 177. https://doi.org/10.3390/jcdd13050177

AMA Style

Karagoz U, Tiryaki ENO, Agirdici EB, Ege B, Tiryaki MM, Ozdemir E, Emren SV. Nutritional Indices Are Associated with Mortality in the Elderly Patients Undergoing Left Atrial Appendage Occlusion: A Comparative Study of CONUT, GNRI, and PNI. Journal of Cardiovascular Development and Disease. 2026; 13(5):177. https://doi.org/10.3390/jcdd13050177

Chicago/Turabian Style

Karagoz, Ugur, Enise Nur Ozlem Tiryaki, Enis Behcet Agirdici, Berke Ege, Muhammet Mucahit Tiryaki, Emre Ozdemir, and Sadık Volkan Emren. 2026. "Nutritional Indices Are Associated with Mortality in the Elderly Patients Undergoing Left Atrial Appendage Occlusion: A Comparative Study of CONUT, GNRI, and PNI" Journal of Cardiovascular Development and Disease 13, no. 5: 177. https://doi.org/10.3390/jcdd13050177

APA Style

Karagoz, U., Tiryaki, E. N. O., Agirdici, E. B., Ege, B., Tiryaki, M. M., Ozdemir, E., & Emren, S. V. (2026). Nutritional Indices Are Associated with Mortality in the Elderly Patients Undergoing Left Atrial Appendage Occlusion: A Comparative Study of CONUT, GNRI, and PNI. Journal of Cardiovascular Development and Disease, 13(5), 177. https://doi.org/10.3390/jcdd13050177

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