Cardiovascular Surgery and Interventions 2024, Vol 11, Num 1 Page(s): 010-017
Clinical significance of CONUT score in atrial fibrillation patients aged 65 and over

Raif Kılıç1, Ahmet Ferhat Kaya2

1Department of Cardiology, Çermik State Hospital, Diyarbakır, Türkiye
2Department of Cardiology, Muş State Hospital, Muş, Türkiye

Keywords: Atrial fibrillation, major bleeding, malnutrition, mortality
Objectives: The aim of this study was to examine the clinical importance of malnutrition in patients with non-valvular atrial fibrillation (AF) aged 65 and over who were receiving anticoagulant treatment and to distinguish the differences between direct oral anticoagulants (DOACs) and warfarin therapy.

Patients and methods: Between January 2016 and December 2020, a total of 423 AF patients (183 males, 240 females; mean age: 73.4±5.8 years; range, 65 to 89 years) were retrospectively analyzed. The patients were divided into two groups according to the Controlling Nutritional Status (CONUT) score: ≥5 (n=92) and <5 (n=331). All patients were followed for at least two years from the first presentation.

Results: Major bleeding and mortality were found to be higher in the CONUT score ≥5 group (8.7% vs. 3.0%, p=0.017 and 18.5% vs. 10.0%, p=0.025, respectively). While there was higher major bleeding and mortality in CONUT ≥5 patients using warfarin, there was no significant difference in the DOAC group (warfarin p=0.009, DOAC p=0.337 and warfarin p=0.046, DOAC p=0.171, respectively). In the receiver operating characteristic analysis, a cut-off value of 3.5 of the CONUT score predicted both mortality and major bleeding (area under the curve [AUC]: 0.781, p<0.001 and AUC: 0.733, p=0.001, respectively).

Conclusion: According to the CONUT score, a higher rate of major bleeding and mortality was found in AF patients aged 65 and over with moderate-severe malnutrition. Based on these findings, the use of DOAC may be more reliable in this patient group.

DOI : 10.5606/e-cvsi.2024.1572