{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:13Z","timestamp":1787018113321,"version":"build-2736575974"},"reference-count":66,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Malnutrition is a critical modifiable risk factor in acute coronary syndrome (ACS). Obstructive sleep apnea (OSA), prevalent in ACS, is associated with adverse outcomes and may also affect nutritional status. This study aims to elucidate the relationship between malnutrition and long\u2010term cardiovascular outcomes in patients with ACS with or without OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This is a subanalysis of the OSA\u2010ACS project, which consecutively enrolled patients with ACS who underwent portable sleep monitoring from June 2015 to January 2020. OSA was defined as an apnea hypopnea index \u226515 events\/hour. Nutritional status was assessed using the Controlling Nutritional Status score, the Nutritional Risk Index, and the Naples Prognostic Score. The relationships between malnutrition and major adverse cardiovascular and cerebrovascular events were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 1756 patients enrolled, 931 (53.0%) had OSA, and the prevalence of malnutrition varied by assessment index: 47.4% (Controlling Nutritional Status score), 23.0% (Nutritional Risk Index), and 87.8% (Naples Prognostic Score). During 2.9 (1.5\u20133.5) years of follow\u2010up, malnutrition was independently associated with the risk of major adverse cardiovascular and cerebrovascular events in patients with OSA (adjusted hazard ratios [aHRs] for moderate\u2010to\u2010severe malnutrition, 2.707 [95% CI, 1.128\u20136.494] for Controlling Nutritional Status score, 1.647 [95% CI, 1.073\u20132.528] for Nutritional Risk Index, and 1.962 [95% CI, 1.069\u20133.601] for Naples Prognostic Score) but not in those without OSA. A linear dose\u2013response relationship between the severity of malnutrition and the risk of major adverse cardiovascular and cerebrovascular events was found in patients with OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">For patients with ACS, malnutrition is independently associated with the risk of cardiovascular events, particularly those with coexisting OSA. Proactive nutritional screening may help identify this high\u2010risk subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043885","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:29:12Z","timestamp":1761888552000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between the Malnutrition Status and Adverse Cardiovascular Outcomes in Patients With Obstructive Sleep Apnea and Acute Coronary Syndrome"],"prefix":"10.1161","volume":"14","author":[{"given":"Yixiang","family":"Liu","sequence":"first","affiliation":[{"name":"Beijing Anzhen Hospital, Capital Medical University","place":["Beijing, China"]},{"name":"National Clinical Research Center for Cardiovascular Diseases","place":["Beijing, China"]},{"name":"Beijing Institute of Heart, Lung, and Blood Vessel Diseases","place":["Beijing, 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