{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T21:45:31Z","timestamp":1792619131454,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) are indices that identify individuals at risk of malnutrition. Our study sought to examine the incidence and prognostic implications of abnormal CONUT and\/or GNRI in patients with heart failure with preserved ejection fraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The CONUT score and GNRI were serially analyzed in this post hoc analysis of the PARAGON\u2010HF (Prospective Comparison of Angiotensin Receptor\u2013Neprilysin Inhibitor With Angiotensin\u2010Receptor Blockers Global Outcomes in Heart Failure With Preserved Ejection Fraction) trial. A CONUT score &gt;2 or GNRI \u226498 was considered to be abnormal. The association between abnormal CONUT and\/or GNRI (analyzed using a time\u2010updated approach) and total heart failure hospitalizations and cardiovascular death was analyzed. Other outcomes included cardiovascular death, all\u2010cause death, total heart failure hospitalizations, first all\u2010cause hospitalization, and first noncardiovascular hospitalization. We also explored the effect of incident hospitalization on subsequent incident abnormal CONUT and\/or GNRI. In 4794 patients (55% women, mean age 72\u00b18\u2009years), 1119 (23.3%) had at least 1 abnormal score at randomization. Among the remaining 3675 patients, 1405 (38.2%) developed at least 1 abnormal score over a median follow\u2010up of 2.9\u2009years. Any abnormal score during follow\u2010up was associated with a significantly higher risk of fatal and nonfatal outcomes, and all types of hospitalizations (all\u2010cause, heart failure, and noncardiovascular hospitalizations). Among patients with normal scores at randomization, any hospitalization during follow\u2010up was associated with a significantly higher risk of developing at least 1 abnormal score posthospitalization, compared with prehospitalization and never\u2010hospitalized patients (adjusted hazard ratio, 1.37 [95% CI, 1.22\u20131.55]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with heart failure with preserved ejection fraction, the rate of individuals with abnormal CONUT and\/or GNRI was high, especially following a heart failure hospitalization, and was linked with excess cardiovascular and noncardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT01920711.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.038872","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T06:53:17Z","timestamp":1745391197000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Prognostic Significance of Nutritional Scores in Patients With Heart Failure: Insights From the PARAGON\u2010HF Trial"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9074-6505","authenticated-orcid":false,"given":"Henri","family":"Lu","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Lausanne University Hospital (CHUV), University of Lausanne (UNIL)","place":["Lausanne, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-9218","authenticated-orcid":false,"given":"Brian L.","family":"Claggett","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Minamisawa","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Shinshu University Hospital","place":["Matsumoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2866-9414","authenticated-orcid":false,"given":"John W.","family":"Ostrominski","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1216-4478","authenticated-orcid":false,"given":"Alberto","family":"Fo\u00e0","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Alma Mater Studiorum University of Bologna","place":["Bologna, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-0654","authenticated-orcid":false,"given":"Maria A.","family":"Pab\u00f3n","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-5686","authenticated-orcid":false,"given":"Arzu","family":"Kalayci","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-5549","authenticated-orcid":false,"given":"Maja","family":"Cikes","sequence":"additional","affiliation":[{"name":"University Hospital Center Zagreb","place":["Zagreb, Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1056-4451","authenticated-orcid":false,"given":"Amil M.","family":"Shah","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-0701","authenticated-orcid":false,"given":"Akshay S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-3975","authenticated-orcid":false,"given":"John J. V.","family":"McMurray","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-5317","authenticated-orcid":false,"given":"Pardeep S.","family":"Jhund","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-2387","authenticated-orcid":false,"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor University Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8830-6316","authenticated-orcid":false,"given":"Martin","family":"Lefkowitz","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceutical Corporation","place":["East Hanover, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5353-3877","authenticated-orcid":false,"given":"Jean L.","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al","place":["Montreal, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-221X","authenticated-orcid":false,"given":"Michael R.","family":"Zile","sequence":"additional","affiliation":[{"name":"Ralph H Johnson Department of Veterans Affairs Health Care System","place":["Charleston, USA"]},{"name":"Medical University of South Carolina","place":["Charleston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d\u2019Investigation Clinique\u2010Plurith\u00e9matique Inserm 1433, Centre Hospitalier R\u00e9gional Universitaire","place":["Nancy, France"]},{"name":"Inserm U1116, CHRU Nancy Brabois, F\u2010CRIN INI\u2010CRCT (Cardiovascular and Renal Clinical Trialists)","place":["Nancy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-8899","authenticated-orcid":false,"given":"Sheila M.","family":"Hegde","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-9597","authenticated-orcid":false,"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5629-4138","authenticated-orcid":false,"given":"Hicham","family":"Skali","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-016-9540-0"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0259300"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.02.018"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.09.004"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.002"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001062"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.04.020"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18590"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-1091"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/82.4.777"},{"key":"e_1_3_1_13_2","first-page":"38","article-title":"CONUT: a tool for controlling nutritional status. 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