Abstract 11910: Prevalence and Variation in Malnutrition in Non-Obstructive Coronary Artery Disease

Introduction: Prior work demonstrates up to 50% of patients with acute coronary syndrome are malnourished, as evaluated by the Controlling Nutritional Status (CONUT) score. We investigated the prevalence of malnutrition in stable nonobstructive coronary artery disease (CAD) detected by coronary computed tomography angiography (CCTA) versus invasive coronary angiography (ICA). Methods: In a single-center, retrospective cohort, we examined the electronic health records of 429 patients with normal coronary arteries (NCA) without evidence of atherosclerosis on CCTA (n=144), nonobstructive CAD (<70% stenosis) by CCTA (n=143), or ICA (n=142) on clinically ordered studies for chest pain or exertional dyspnea. CONUT scores, an aggregate of albumin, lymphocyte count, and total cholesterol, were calculated at time of CCTA or ICA in patients with available lab values. Patients within each group were stratified by severity of malnutrition defined as none (0-1), mild (2-4), moderate (5-7), or severe (8-12). Diabetic patients were excluded. Number of risk factors including history of hypertension, hyperlipidemia, or smoking were compared. Results: Among all patients with complete data (n=332), 33% overall had malnutrition, including 31% with mild, 2% with moderate, and none with severe malnutrition. In patients with NCA, 24% had malnutrition, compared to 31% in nonobstructive CAD by CCTA and 45% in ICA. There was a direct positive relationship between malnutrition presence and severity with age, cardiac risk factors and the presence of nonobstructive CAD ( Table ). Conclusions: Malnutrition is present in over one-third of stable patients with no obstructive CAD and directly associated with age, risk factor burden, and nonobstructive CAD. Future prospective studies are needed to understand whether malnutrition directly contributes to development of CAD or if age and cardiac risk factors associated with CAD lead to progression of malnutrition, or both.