The DOI matches its Crossref record; 220 of the 220 references it cites were found in a registry or an index; 48 of the 142 sources its claims cite were checked for support.
Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association
Open accessAbstract
Malnutrition can affect patients with various acute cardiovascular disease conditions, including acute coronary syndromes, arrhythmias, or valvular disease; however, most of the literature has focused on patients with heart failure. Malnutrition prevalence estimates range from 20% to 60% for hospitalized patients. Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality. Nutritional support plays a key role for inpatients, particularly in the cardiac intensive care unit, and includes initiation of feeding within 48 hours of hospitalization, preferably through enteral nutrition. Enteral nutrition is more cost-effective compared with parenteral nutrition and can decrease mortality and shorten lengths of stay. Parenteral nutrition is reserved for patients with severe gastrointestinal dysfunction or to supplement nutrition when enteral nutrition is contraindicated, for example, during high pressor doses that preclude adequate intestinal perfusion or when achieving <70% of nutritional targets after the first week. The optimal protein intake for patients with cardiogenic shock is an area of ongoing research, with higher protein approaches not appearing beneficial in recent critical care trials.
Overview
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Written from the paper’s full text.
TL;DR
This American Heart Association scientific statement reviews malnutrition and cachexia in inpatients with acute cardiac conditions, emphasizing GLIM-based diagnosis, prevalence estimates of 20% to 60%, and nutrition support principles. It recommends early enteral nutrition within 48 hours when feasible, reserves parenteral nutrition for specific contraindications, and highlights major evidence gaps in cardiac critical care.
Key findings
- Malnutrition prevalence in acute cardiovascular disease ranges widely from 20% to 60%, depending on diagnostic criteria and population; GLIM criteria have confirmed prognostic value, correlating with poorer physical function and higher mortality.
- In the EFFORT trial, individualized nutritional support reduced 30-day adverse clinical outcomes (adjusted OR, 0.79 [95% CI, 0.64–0.97]; P=0.023) and 30-day mortality (adjusted OR, 0.65 [95% CI, 0.47–0.91]; P=0.011); a post hoc chronic HF analysis showed lower 30-day mortality (OR, 0.44 [95% CI, 0.26–0.75]; P=0.002).
- Enteral nutrition is preferred over parenteral nutrition, should be initiated within 48 hours of hospitalization when feasible, and PN is reserved for severe gastrointestinal dysfunction or when EN is contraindicated or achieves <70% of nutritional targets after the first week.
- Higher protein approaches have not appeared beneficial in recent critical care trials; the statement notes that protein intake targets of 1.2 to 2.0 g·kg−1·d−1 are favored by ASPEN/SCCM guidance, while >2.0 g·kg−1·d−1 has not proved beneficial in mechanically ventilated patients.
Methods
- Design: A scientific statement from the American Heart Association Acute Cardiac Care and General Cardiology Committee, synthesizing evidence and providing consensus recommendations rather than conducting a primary study.
- Data or sample: No original patient sample; the statement reviews and cites existing literature, including trials and cohorts such as EFFORT, SODIUM-HF, SCOFF, NUTRIREA-2/3, EFFORT Protein, PRECISe, PICNIC, and GOURMET-HF.
- Main analysis: Narrative synthesis of evidence on prevalence, diagnosis, pathophysiology, inpatient and critical care nutrition support, postdischarge nutrition, and research gaps, with recommendations presented in text and tables/figures.
Limitations
- The paper states multiple knowledge gaps: lack of consensus on the most appropriate validated malnutrition tool for cardiac inpatients, unknown optimal body composition assessment for cachexia/sarcopenia, inadequate high-quality nutritional evidence in acutely and critically ill CVD patients, and no studies evaluating the impact of registered dietitian nutritionists on outcomes in the cardiac intensive care unit.
- The paper notes that many cited trials were not designed specifically for CVD or CICU populations, including EFFORT, and that data for cardiogenic shock and cardiac arrest are limited or extrapolated from general critical care.
- Evident from the text: as a scientific statement, it is not a systematic review or meta-analysis and does not report a formal search strategy, risk-of-bias assessment, or quantitative pooling; recommendations rely on expert consensus and available evidence.
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Claims the paper makes
32 No full text of the sources · 19 Partly supported · 18 Not checked yet · 8 Supported · 6 Own interpretation · 5 Not supported · 3 No basis given · 2 Supported so far · 2 Couldn’t confirm · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“In this study, calorie and protein restriction did not affect survival but was associated with lower complications, including less bowel ischemia and liver disease, and with shorter ICU stay.156”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Disputedcites [156] Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM; CALORIES Trial Investigators. Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014; 371: 1673– 1684. doi: 10.1056/NEJMoa1409860 25271389 sourceExperimental — accuracy not yet measured
The Methods (p. 1) describe a trial comparing parenteral with enteral delivery, not calorie and protein restriction in patients with shock. The Discussion (p. 8) reports no significant difference in ICU length of stay or infectious complications between groups, contrary to the cited sentence; it does not report reduced bowel ischemia or liver disease. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“In this study, calorie and protein restriction did not affect survival but was associated with lower complications, including less bowel ischemia and liver disease, and with shorter ICU stay.156”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Disputedcites [156] Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM; CALORIES Trial Investigators. Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014; 371: 1673– 1684. doi: 10.1056/NEJMoa1409860 25271389 sourceExperimental — accuracy not yet measured
The Study Interventions (p. 2) compare enteral with parenteral delivery, not calorie and protein restriction, and the Discussion (p. 11) says the study leaves nutritional dose unanswered. Although the Discussion (p. 8) reports no significant mortality difference by route, it also reports no significant difference in ICU length of stay, contrary to the cited sentence’s claim of a shorter stay. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“mesenteric ischemia carries a mortality exceeding 75%.141”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > General Principles
What the sources say
- Disputedcites [141] Leone M, Bechis C, Baumstarck K, Ouattara A, Collange O, Augustin P, Annane D, Arbelot C, Asehnoune K, Baldesi O, Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases. Intensive Care Med. 2015; 41: 667– 676. doi: 10.1007/s00134-015-3690-8 25731634 sourceExperimental — accuracy not yet measured
The Abstract reports a 58% death rate among 780 ICU patients with acute mesenteric ischemia, not a rate exceeding 75%. The Discussion also gives a previously reported operative mortality range of 26–72%; its near-100% figure applies specifically to missed cases that did not undergo surgery. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“In this study, calorie and protein restriction did not affect survival but was associated with lower complications, including less bowel ischemia and liver disease, and with shorter ICU stay.156”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Disputedcites [156] Harvey SE, Parrott F, Harrison DA, Bear DE, Segaran E, Beale R, Bellingan G, Leonard R, Mythen MG, Rowan KM; CALORIES Trial Investigators. Trial of the route of early nutritional support in critically ill adults. N Engl J Med. 2014; 371: 1673– 1684. doi: 10.1056/NEJMoa1409860 25271389 sourceExperimental — accuracy not yet measured
The Study Interventions (p. 2) describe a comparison of parenteral versus enteral feeding, not a trial of calorie and protein restriction in shock. The Discussion (p. 8) explicitly reports no significant difference in ICU length of stay between the groups, contrary to the claimed shorter stay. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Risk factors for mesenteric ischemia in venoarterial extracorporeal membrane oxygenation have included renal replacement therapy and higher vasopressor dosing but not timing or route of nutritional support.162”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Disputedcites [162] Renaudier M, de Roux Q, Bougouin W, Boccara J, Dubost B, Attias A, Fiore A, de’Angelis N, Folliguet T, Mule S, Acute mesenteric ischaemia in refractory shock on veno-arterial extracorporeal membrane oxygenation. Eur Heart J Acute Cardiovasc Care. 2020; 10: 62– 70. doi: 10.1177/2048872620915655 33609105 sourceExperimental — accuracy not yet measured
The ‘Variables associated with acute mesenteric ischaemia’ section supports the RRT association and reports higher norepinephrine doses in affected patients. But it directly contradicts the claim about nutritional support: initiation of enteral nutrition in the first five days was negatively associated with ischaemia onset. The paper does not establish that vasopressor dose was an independent risk factor. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Malnutrition prevalence estimates range from 20% to 60% for hospitalized patients.”
- Also stated in: § Abstract · plain
“The prevalence of malnutrition in patients with acute cardiovascular disease (CVD) ranges widely between 20% and 60%, depending on diagnostic criteria and the population studied7,8 (Table 1).”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > Abstract
What the sources say
- Partly supportedcites [7] Hirose S, Matsue Y, Kamiya K, Kagiyama N, Hiki M, Dotare T, Sunayama T, Konishi M, Saito H, Saito K, Prevalence and prognostic implications of malnutrition as defined by GLIM criteria in elderly patients with heart failure. Clin Nutr. 2021; 40: 4334– 4340. doi: 10.1016/j.clnu.2021.01.014 33551220 sourceExperimental — accuracy not yet measured
The Discussion reports malnutrition in 42.4% of hospitalized elderly patients with heart failure who could ambulate, a figure within the claimed range. It does not establish a 20%–60% range for hospitalized patients generally; the range it discusses for patients with heart failure is 16%–90%. No page number is available in our copy. (LLM, conf=0.85)
- Partly supportedcites [8] Cass AR, Charlton KE. Prevalence of hospital-acquired malnutrition and modifiable determinants of nutritional deterioration during inpatient admissions: a systematic review of the evidence. J Hum Nutr Diet. 2022; 35: 1043– 1058. doi: 10.1111/jhn.13009 35377487 PMC9790482 sourceExperimental — accuracy not yet measured
The Introduction states that malnutrition affects 20%–50% of hospital inpatients, supporting the lower bound but not the claimed 60% upper bound. The Results report rates up to 65% for nutritional deterioration during admission, which is a different measure from malnutrition prevalence. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Abstract · plain
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The malnutrition prevalence estimates ranging from 20% to 60% for hospitalized patients are probably underestimates resulting from limitations in documentation, coding, and diagnostic criteria.8”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE
What the sources say
- Partly supportedcites [8] Cass AR, Charlton KE. Prevalence of hospital-acquired malnutrition and modifiable determinants of nutritional deterioration during inpatient admissions: a systematic review of the evidence. J Hum Nutr Diet. 2022; 35: 1043– 1058. doi: 10.1111/jhn.13009 35377487 PMC9790482 sourceExperimental — accuracy not yet measured
The Introduction (page not provided) gives a 20%–50% prevalence range for hospital inpatients, not 20%–60%. The Discussion (page not provided) says assessment and reporting methods may underestimate hospital-acquired malnutrition, but it does not attribute underestimation of the stated inpatient prevalence range to documentation and coding limitations. (LLM, conf=0.87)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Inadequate micronutrient intake has been associated with higher mortality and cardiovascular events in patients with HF.106,107”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Partly supportedcites [106] Lennie TA, Andreae C, Rayens MK, Song EK, Dunbar SB, Pressler SJ, Heo S, Kim J, Moser DK. Micronutrient deficiency independently predicts time to event in patients with heart failure. J Am Heart Assoc. 2018; 7: e007251. doi: 10.1161/JAHA.117.007251 30371170 PMC6201427 sourceExperimental — accuracy not yet measured
The Results (page not provided) associate high dietary micronutrient deficiency with a greater hazard of the combined outcome of all-cause hospitalization or death in patients with heart failure. They do not establish higher mortality or cardiovascular events as separate outcomes; the reported hospitalizations and deaths were all-cause. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [107] Song EK, Kang S-M. Micronutrient deficiency independently predicts adverse health outcomes in patients with heart failure. J Cardiovasc Nurs. 2017; 32: 47– 53. doi: 10.1097/JCN.0000000000000304 26544174 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In patients receiving maintenance dialysis, protein requirements may be closer to 1.2 to 1.3 g·kg−1·d−1129 as a result of dialysis-related protein loss and systemic inflammation.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Supportedcites [129] Zha Y, Qian Q. Protein nutrition and malnutrition in CKD and ESRD. Nutrients. 2017; 9: 208. doi: 10.3390/nu9030208 28264439 PMC5372871 source
Section 4 states that patients on maintenance hemodialysis or peritoneal dialysis have a protein requirement of 1.2–1.3 g/kg/day. It attributes the higher requirement in part to dialysis-related protein loss and persistent inflammation. (LLM, conf=0.94)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“To date, improvements in dietary quality rather than restrictive dietary counseling have shown benefits in primary and secondary CVD prevention,98,99”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > OPPORTUNITIES FOR NUTRITIONAL INTERVENTIONS IN THE INPATIENT AND POSTDISCHARGE SETTINGS
What the sources say
- Not checked — no full text of the sourcecites [98] Delgado-Lista J, Alcala-Diaz JF, Torres-Pena JD, Quintana-Navarro GM, Fuentes F, Garcia-Rios A, Ortiz-Morales AM, Gonzalez-Requero AI, Perez-Caballero AI, Yubero-Serrano EM,; CORDIOPREV Investigators. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022; 399: 1876– 1885. doi: 10.1016/S0140-6736(22)00122-2 35525255 source
- Partly supportedcites [99] Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F, Gomez-Gracia E, Ruiz-Gutierrez V, Fiol M, Lapetra J,; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018; 378: e34. doi: 10.1056/NEJMoa1800389 29897866 sourceExperimental — accuracy not yet measured
The Discussion (p. 12) reports fewer cardiovascular events with an energy-unrestricted Mediterranean diet than with advice to follow a reduced-fat diet, supporting the primary-prevention part. The paper also mentions a secondary-prevention trial associated with lower cardiovascular risk (p. 2), but it does not establish that improving dietary quality outperforms restrictive dietary counseling for secondary prevention. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 36
- Probably not a substantial claim. 5
- The quote only partly states this claim. 2
Every source the paper cites for this claim was checked and supports it.
In the paper
“Specifically in HF, a low-flow or congestive state impairs nutrient delivery and absorption, with associated decreased appetite, gastrointestinal dysfunction, and malnutrition.94”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PATHOPHYSIOLOGY OF MALNUTRITION AND CACHEXIA IN INPATIENTS WITH CARDIAC CONDITIONS
What the sources say
- Supportedcites [94] Esteban-Fernandez A, Villar-Taibo R, Alejo M, Arroyo D, Bonilla Palomas JL, Cachero M, Joaquin C, Mendez Bailon M, Perez-Rivera JA, Romero-Vigara JC, Diagnosis and management of malnutrition in patients with heart failure. J Clin Med. 2023; 12: 3320. doi: 10.3390/jcm12093320 37176761 PMC10179706 source
Section 2.1 (Hemodynamic Alterations; page unavailable) links heart failure to tissue hypoperfusion and intestinal congestion, which can cause satiety, nausea, reduced intake, and enteric albumin loss. Section 2 (Causes and Pathophysiological Mechanisms; page unavailable) also states that heart failure can cause malnutrition through altered appetite, food intake, and nutrient malabsorption. Together, these support the citing sentence as a broad paraphrase. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“There are, however, safety concerns about augmenting dietary protein above the 0.8 g·kg−1·d−1 range, especially from animal sources, because of concerns of accelerating coronary artery disease and HF incidence, as well as the potential for accelerating CKD progression.123–125”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Partly supportedcites [123] Virtanen HEK, Voutilainen S, Koskinen TT, Mursu J, Tuomainen T-P, Virtanen JK. Intake of different dietary proteins and risk of heart failure in men. Circ Heart Fail. 2018; 11: 1– 12. doi: 10.1161/circheartfailure.117.004531 PMC6023591 29844244 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [124] Wang Z, Bergeron N, Levison BS, Li XS, Chiu S, Jia X, Koeth RA, Li L, Wu Y, Tang WHW, Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women. Eur Heart J. 2019; 40: 583– 594. doi: 10.1093/eurheartj/ehy799 30535398 PMC6374688 sourceExperimental — accuracy not yet measured
The Discussion (page not supplied) describes an association between red-meat consumption and cardiovascular risk, supporting that part of the safety concern. It does not establish a risk threshold above 0.8 g/kg/day, address heart-failure incidence, or show that increased protein intake accelerates chronic kidney disease progression; its renal findings concern metabolite excretion in healthy participants. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [125] Levey AS, Greene T, Sarnak MJ, Wang X, Beck GJ, Kusek JW, Collins AJ, Kopple JD. Effect of dietary protein restriction on the progression of kidney disease: long-term follow-up of the Modification of Diet in Renal Disease (MDRD) study. Am J Kidney Dis. 2006; 48: 879– 888. doi: 10.1053/j.ajkd.2006.08.023 17162142 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In fact, sarcopenic obesity, when lean mass wasting and fat mass expansion occur concurrently, is increasingly recognized and may incur a distinct phenotype of low physical functioning and higher mortality rates, especially in older adults with HF.87,88”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DISTINCTIONS BETWEEN MALNUTRITION AND CACHEXIA, SARCOPENIA, AND FRAILTY
What the sources say
- Supportedcites [87] Saito H, Matsue Y, Kamiya K, Kagiyama N, Maeda D, Endo Y, Ueno H, Yoshioka K, Mizukami A, Saito K, Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF. BMC Geriatr. 2022; 22: 556. doi: 10.1186/s12877-022-03168-3 35787667 PMC9254413 source
The Background defines sarcopenic obesity as reduced lean body mass alongside excess adiposity. The Abstract Results report lower physical-performance scores, shorter walking distance, and higher one-year mortality in the sarcopenia/obesity group of older patients hospitalized with heart failure; the Conclusion identifies it as a risk factor for low physical function and all-cause death. (LLM, conf=0.91)
- Partly supportedcites [88] Billingsley HE, Del Buono MG, Canada JM, Kim Y, Damonte JI, Trankle CR, Halasz G, Mihalick V, Vecchie A, Markley RR, Sarcopenic obesity is associated with reduced cardiorespiratory fitness compared with nonsarcopenic obesity in patients with heart failure with reduced ejection fraction. Circ Heart Fail. 2022; 15: e009518. doi: 10.1161/CIRCHEARTFAILURE.122.009518 36098058 PMC9588574 sourceExperimental — accuracy not yet measured
The Introduction (page unavailable) defines sarcopenic obesity as excess fat mass with reduced skeletal muscle mass and describes greater functional impairment. The Discussion (page unavailable) reports poorer cardiorespiratory fitness in patients with obesity and heart failure with reduced ejection fraction. The paper does not establish higher mortality rates from sarcopenic obesity in older adults with heart failure; its Introduction links low peak oxygen consumption to mortality risk in heart failure more generally. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Malnutrition, cachexia, sarcopenia, and frailty are phenotypically distinct but interconnected conditions with interrelated pathophysiological processes that lead to different magnitudes of wasting and susceptibility to adverse outcomes.81–83”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DISTINCTIONS BETWEEN MALNUTRITION AND CACHEXIA, SARCOPENIA, AND FRAILTY
What the sources say
- Not checked — no full text of the sourcecites [81] Jeejeebhoy KN. Malnutrition, fatigue, frailty, vulnerability, sarcopenia and cachexia: overlap of clinical features. Curr Opin Clin Nutr Metab Care. 2012; 15: 213– 219. doi: 10.1097/MCO.0b013e328352694f 22450775 source
- Not checked — no full text of the sourcecites [82] Severin R, Berner PM, Miller KL, Mey J. The crossroads of aging: an intersection of malnutrition, frailty, and sarcopenia. Topics Geriatr Rehabil. 2019; 35: 79– 87. doi: 10.1097/tgr.0000000000000218 source
- Partly supportedcites [83] Ijaz N, Buta B, Xue QL, Mohess DT, Bushan A, Tran H, Batchelor W, deFilippi CR, Walston JD, Bandeen-Roche K, Interventions for frailty among older adults with cardiovascular disease: JACC state-of-the-art review. J Am Coll Cardiol. 2022; 79: 482– 503. doi: 10.1016/j.jacc.2021.11.029 35115105 PMC8852369 sourceExperimental — accuracy not yet measured
The DOMAINS AND DEFINITIONS section links sarcopenia and unintentional weight loss to frailty and describes a nutritional domain of frailty. It does not establish that malnutrition, cachexia, sarcopenia, and frailty are four phenotypically distinct but interconnected conditions, or compare their magnitudes of wasting and susceptibility to adverse outcomes. Page numbers were not available in our copy. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In addition, BMI is now viewed as a flawed metric for representing normative weight ranges because of its insensitivity to differences in body type and lean versus fat mass and inconsistency across race and sex groups.76–80”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DIAGNOSIS OF MALNUTRITION IN ACUTE CARDIAC CONDITIONS
What the sources say
- Supportedcites [76] Pray R, Riskin S. The history and faults of the body mass index and where to look next: a literature review. Cureus. 2023; 15: e48230. doi: 10.7759/cureus.48230 38050494 PMC10693914 source
The Review says BMI can label people with greater muscle mass and less central adiposity as overweight, and describes racial differences in the relationship between BMI and adiposity. Its Sex Considerations discussion says the same BMI cutoffs do not adequately reflect differences between men and women. The Conclusions call for an alternative that accounts for sex, race, and abdominal adiposity. (LLM, conf=0.91)
- Supportedcites [77] Sweatt K, Garvey WT, Martins C. Strengths and limitations of BMI in the diagnosis of obesity: what is the path forward? Curr Obes Rep. 2024; 13: 584– 595. doi: 10.1007/s13679-024-00580-1 38958869 PMC11306271 source
The “BMI: Strengths and Limitations as a Diagnostic Tool” section says BMI does not directly measure adiposity, can overestimate it in people with high muscle mass and underestimate it in people with low lean mass. It also reports race and sex differences in BMI’s relationship to health outcomes and describes lower BMI thresholds for some populations. These passages support the cited characterization of BMI’s limitations for weight classification. (LLM, conf=0.93)
- Partly supportedcites [78] Tham KW, Abdul Ghani R, Cua SC, Deerochanawong C, Fojas M, Hocking S, Lee J, Nam TQ, Pathan F, Saboo B, Obesity in South and Southeast Asia: a new consensus on care and management. Obes Rev. 2023; 24: e13520. doi: 10.1111/obr.13520 36453081 PMC10078503 sourceExperimental — accuracy not yet measured
In Results, Question 1 (page not provided), the paper says BMI’s relationship to body fat varies by ethnicity and that BMI can underestimate body fat in South Asian children because they have lower lean body mass at a given weight. This supports limitations concerning ethnicity and lean versus fat mass, but the cited passages do not establish the broader claim about differences in body type or inconsistency across sex groups. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [79] WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004; 363: 157– 163. doi: 10.1016/S0140-6736(03)15268-3 14726171 source
- Supportedcites [80] Rubino F, Cummings DE, Eckel RH, Cohen RV, Wilding JPH, Brown WA, Stanford FC, Batterham RL, Farooqi IS, Farpour-Lambert NJ, Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025: 13: 221– 262. doi: 10.1016/S2213-8587(24)00316-4 39824205 PMC11870235 source
In “The BMI issue,” the paper says BMI cannot distinguish fat from lean mass and can misclassify people with different body compositions, including athletes and people of certain ethnicities. In “Clinical assessment of obesity status,” it recommends BMI cutoffs appropriate to sex and ethnicity. These passages support the claim, although the paper discusses ethnicity rather than using the term race. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The unintentional weight loss of cachexia is predominantly loss of muscle mass with or without loss of fat; however, not all individuals with sarcopenia are cachectic.86”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DISTINCTIONS BETWEEN MALNUTRITION AND CACHEXIA, SARCOPENIA, AND FRAILTY
What the sources say
- Partly supportedcites [86] Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, Bahrainy S, Ji Kwak M, Batchelor WB, Forman DE, Sarcopenia and cardiovascular diseases. Circulation. 2023; 147: 1534– 1553. doi: 10.1161/CIRCULATIONAHA.123.064071 37186680 PMC10180053 sourceExperimental — accuracy not yet measured
The Definitions section distinguishes sarcopenia from cachexia, supporting the point that not everyone with sarcopenia is cachectic. It also describes sarcopenic obesity, but our copy does not state that cachexia-related weight loss is predominantly muscle loss with or without fat loss (searched: cachexia and involuntary weight loss). (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“For instance, GLIM criteria identified a higher malnutrition prevalence than International Classification of Disease,10th Revision codes in a large cohort of 2 multicenter observational studies with 2794 patients with cancer; malnutrition according to GLIM was nearly twice as prevalent (23% versus 12.6%).72”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DIAGNOSIS OF MALNUTRITION IN ACUTE CARDIAC CONDITIONS
What the sources say
- Supportedcites [72] Poulter S, Steer B, Baguley B, Edbrooke L, Kiss N. Comparison of the GLIM, ESPEN and ICD-10 criteria to diagnose malnutrition and predict 30-day outcomes: an observational study in an oncology population. Nutrients. 2021; 13: 2602. doi: 10.3390/nu13082602 34444762 PMC8402162 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelationaln = 2,794- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Aging and chronic diseases such as CVD are 2 principal risk factors for the wasting continuum, and these conditions adversely influence outcomes for older adults with CVD at greater risk of disability and mortality.91,92”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DISTINCTIONS BETWEEN MALNUTRITION AND CACHEXIA, SARCOPENIA, AND FRAILTY
What the sources say
- Partly supportedcites [91] Damluji Abdulla A, Bernacki G, Afilalo J, Lyubarova R, Orkaby Ariela R, Kwak Min J, Hummel S, Kirkpatrick James N, Maurer Mathew S, Wenger N, TAVR in older adults. JACC Adv. 2024; 3: 100877. doi: 10.1016/j.jacadv.2024.100877 38694996 PMC11062620 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [92] Damluji AA, Nanna MG, Rymer J, Kochar A, Lowenstern A, Baron SJ, Narins CR, Alkhouli M. Chronological vs biological age in interventional cardiology: a comprehensive approach to care for older adults: JACC family series. JACC Cardiovasc Interv. 2024; 17: 961– 978. doi: 10.1016/j.jcin.2024.01.284 38597844 PMC11097960 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Dietary protein is generally considered a major determinant of muscle mass,118 but it is controversial whether enhanced dietary macronutrient intake can overcome the inflammatory catabolic metabolism of advanced cardiac conditions and achieve net gains in fat-free mass.119,120”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Partly supportedcites [118] Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013; 14: 542– 559. doi: 10.1016/j.jamda.2013.05.021 23867520 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [119] Billingsley HE, Hummel SL, Carbone S. The role of diet and nutrition in heart failure: a state-of-the-art narrative review. Prog Cardiovasc Dis. 2020; 63: 538– 551. doi: 10.1016/j.pcad.2020.08.004 32798501 PMC7686142 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
- Partly supportedcites [120] Katano S, Yano T, Kouzu H, Ohori K, Shimomura K, Honma S, Nagaoka R, Inoue T, Takamura Y, Ishigo T, Energy intake during hospital stay predicts all-cause mortality after discharge independently of nutritional status in elderly heart failure patients. Clin Res Cardiol. 2021; 110: 1202– 1220. doi: 10.1007/s00392-020-01774-y 33399954 PMC8318973 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A post hoc analysis of participants with chronic HF demonstrated that the group receiving RDN-led deployment of tailored nutritional interventions experienced lower 30-day mortality (odds ratio, 0.44 [ 95% CI, 0.26–0.75]; P=0.002), with a particularly marked effect”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Partly supportedcites [105] Hersberger L, Dietz A, Burgler H, Bargetzi A, Bargetzi L, Kagi-Braun N, Tribolet P, Gomes F, Hoess C, Pavlicek V, Individualized nutritional support for hospitalized patients with chronic heart failure. J Am Coll Cardiol. 2021; 77: 2307– 2319. doi: 10.1016/j.jacc.2021.03.232 33958128 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“the most appropriate protein intake approaches for the CICU population are likely those in alignment with evidence-based guidance from ASPEN and the Society of Critical Care Medicine, which favor individualized protein intake targets within the 1.2– to 2.0–g·kg−1·d−1 range, with cautious consideration of higher intake in select patients with burns, trauma, or obesity.148–150”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > General Principles
What the sources say
- Supportedcites [148] McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA,; Society of Critical Care Medicine. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016; 40: 159– 211. doi: 10.1177/0148607115621863 26773077 source
Section C4 recommends 1.2–2.0 g/kg of actual body weight per day and says requirements may be higher in burn or multitrauma patients. The obesity recommendation gives higher targets based on ideal body weight, while the rationale calls for ongoing assessment of protein adequacy. The separate burns recommendation specifies 1.5–2.0 g/kg/day; the cited passages provide section labels but no page numbers. (LLM, conf=0.89)
- Not checked yetcites [149] Compher C, Bingham AL, McCall M, Patel J, Rice TW, Braunschweig C, McKeever L. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022; 46: 12– 41. doi: 10.1002/jpen.2267 34784064 source
Checked before — its earlier verdict is held back until a new check runs.
- Not checked — no full text of the sourcecites [150] Gramlich L, Guenter P. Enteral nutrition in hospitalized adults. N Engl J Med. 2025; 392: 1518– 1530. doi: 10.1056/NEJMra2406954 40239069 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“EN is more cost-effective; has lower rates of infection, overfeeding, and hyperglycemia compared with PN19,134,135”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > General Principles
What the sources say
- Not checked — no full text of the sourcecites [19] Frederiks P, Peetermans M, Wilmer A. Nutritional support in the cardiac intensive care unit. Eur Heart J Acute Cardiovasc Care. 2024; 13: 373– 379. doi: 10.1093/ehjacc/zuae018 38333990 source
- Not checked — no full text of the sourcecites [134] Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA,; Society of Critical Care Medicine. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016; 44: 390– 438. doi: 10.1097/CCM.0000000000001525 26771786 source
- Partly supportedcites [135] Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, Mayer K, Montejo-Gonzalez JC, Pichard C, Preiser JC, ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr. 2023; 42: 1671– 1689. doi: 10.1016/j.clnu.2023.07.011 37517372 sourceExperimental — accuracy not yet measured
The Commentary reports a meta-analysis finding fewer ICU infections with EN than PN, but says the difference was absent when energy delivery was similar. It suggests caloric overfeeding may contribute to infections associated with PN; it does not report lower overfeeding rates with EN. Its discussion of hyperglycemia does not compare rates between EN and PN. The indexed passages provide section labels but no page numbers. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The European Society for Clinical Nutrition and Metabolism135 recommends a more aggressive approach with early initiation of EN based on recent evidence139 compared with the more conservative approach of ASPEN.134”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > General Principles
What the sources say
- Partly supportedcites [135] Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, Mayer K, Montejo-Gonzalez JC, Pichard C, Preiser JC, ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr. 2023; 42: 1671– 1689. doi: 10.1016/j.clnu.2023.07.011 37517372 sourceExperimental — accuracy not yet measured
Section 3.2.1 recommends starting enteral nutrition within 48 hours for critically ill adults who cannot eat orally. The Commentary discusses ASPEN/SCCM guidance but does not establish that ASPEN takes a more conservative approach to initiation, so the comparison is unsupported by this source. (LLM, conf=0.85)
- Partly supportedcites [139] Reignier J, Plantefeve G, Mira JP, Argaud L, Asfar P, Aissaoui N, Badie J, Botoc NV, Brisard L, Bui HN,; NUTRIREA-3 Trial Investigators. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3). Lancet Respir Med. 2023; 11: 602– 612. doi: 10.1016/S2213-2600(23)00092-9 36958363 sourceExperimental — accuracy not yet measured
The Summary states that international guidelines recommend starting nutritional support within 48 hours, preferably by the enteral route when not contraindicated. But the Methods show that NUTRIREA-3 compared calorie and protein targets, not early versus delayed enteral nutrition; its text does not establish that ESPEN recommends earlier initiation than ASPEN. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [134] Taylor BE, McClave SA, Martindale RG, Warren MM, Johnson DR, Braunschweig C, McCarthy MS, Davanos E, Rice TW, Cresci GA,; Society of Critical Care Medicine. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016; 44: 390– 438. doi: 10.1097/CCM.0000000000001525 26771786 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“1 trial including 30% of patients with HF and 2% with CS demonstrated that EN continuation during MV liberation was associated with shorter extubation times, shorter MV duration, better achievement of caloric goals, lower mortality, and less hypoglycemia without differences in aspiration events compared with EN interruption.155”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Partly supportedcites [155] Landais M, Nay MA, Auchabie J, Hubert N, Frerou A, Yehia A, Mercat A, Jonas M, Martino F, Moriconi M,; REVA Network and CRICS-TriggerSEP F-CRIN Research Network. Continued enteral nutrition until extubation compared with fasting before extubation in patients in the intensive care unit: an open-label, cluster-randomised, parallel-group, non-inferiority trial. Lancet Respir Med. 2023; 11: 319– 328. doi: 10.1016/S2213-2600(22)00413-1 36693402 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Although not good markers of nutritional status, albumin <3.0 g/dL and prealbumin ≤20 mg/dL have been used as acute-phase markers to trigger nutritional supplementation within 1 week of surgery.186,189–191”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR PATIENTS UNDERGOING CARDIAC PROCEDURES > Cardiac Surgery
What the sources say
- Partly supportedcites [186] Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, Roselli EE, Khoynezhad A, Gerdisch M, Levy JH, Guidelines for perioperative care in cardiac surgery: Enhanced Recovery After Surgery society recommendations. JAMA Surg. 2019; 154: 755– 766. doi: 10.1001/jamasurg.2019.1153 31054241 sourceExperimental — accuracy not yet measured
The 'Preoperative Correction of Nutritional Deficiency' section says that 7–10 days of intensive nutrition therapy may improve outcomes for cardiac-surgery patients with albumin below 3.0 g/dL. It does not give a prealbumin threshold of ≤20 mg/dL, describe either measure as an acute-phase marker or a poor marker of nutritional status, or recommend starting supplementation within one week of surgery. Page numbers are unavailable in our copy. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [189] Yu P-J, Cassiere HA, Dellis SL, Manetta F, Kohn N, Hartman AR. Impact of preoperative prealbumin on outcomes after cardiac surgery. JPEN J Parenter Enteral Nutr. 2015; 39: 870– 874. doi: 10.1177/0148607114536735 24898210 source
- Not checked — no full text of the sourcecites [190] Lauck SB, Wood DA, Achtem L, Baumbusch J, Boone RH, Cheung A, Dvir D, Stub D, Tan JS, Ye J, Risk stratification and clinical pathways to optimize length of stay after transcatheter aortic valve replacement. Can J Cardiol. 2014; 30: 1583– 1587. doi: 10.1016/j.cjca.2014.07.012 25475463 source
- Not checked — no full text of the sourcecites [191] Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015; 123: 1455– 1472. doi: 10.1097/ALN.0000000000000795 26248016 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“European recommendations have adopted evidence for clear liquids up to 2 hours before and a light meal up to 6 hours before surgery.180,188,193”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR PATIENTS UNDERGOING CARDIAC PROCEDURES > Cardiac Surgery
What the sources say
- Not checked — no full text of the sourcecites [180] Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017; 126: 376– 393. doi: 10.1097/ALN.0000000000001452 28045707 source
- Could not verifycites [188] Stoppe C, Goetzenich A, Whitman G, Ohkuma R, Brown T, Hatzakorzian R, Kristof A, Meybohm P, Mechanick J, Evans A, Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Crit Care. 2017; 21: 131. doi: 10.1186/s13054-017-1690-5 28583157 PMC5460477 sourceExperimental — accuracy not yet measured
The 'Optimal time point for perioperative nutrition therapy' section discusses nutrition support before cardiac surgery, but does not address fasting allowances. Searches for clear liquids, light meals, and European preoperative fasting recommendations found no passage in our copy stating the two-hour and six-hour limits. (LLM, conf=0.73)
- Not checked — no full text of the sourcecites [193] Brady M, Kinn S, Stuart P. Preoperative fasting for adults to prevent perioperative complications. Cochrane Database Syst Rev. 2003: CD004423. doi: 10.1002/14651858.CD004423 14584013 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality.”
- Also stated in: § PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE · boosted
“Use of Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria for patients with CVD has confirmed prognostic value, demonstrating associations with poorer physical function and higher mortality.35”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > Abstract
What the sources say
- Not checked — no full text of the sourcecites [35] Kootaka Y, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Nakamura T, Yamashita M, Maekawa E, Reed JL, Yamaoka-Tojo M, The GLIM criteria for defining malnutrition can predict physical function and prognosis in patients with cardiovascular disease. Clin Nutr. 2021; 40: 146– 152. doi: 10.1016/j.clnu.2020.04.038 32571679 source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE · boosted
In the paper
“The predictive validity of the Academy of Nutrition and Dietetics/ASPEN indicators for diagnosing malnutrition tool was recently confirmed across 290 adult inpatients in whom both the original tool and a simplified version showed association with emergency department visits and hospital readmissions for patients with severe malnutrition and longer lengths of stay and greater”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DIAGNOSIS OF MALNUTRITION IN ACUTE CARDIAC CONDITIONS
What the sources say
- Not checked — no full text of the sourcecites [70] Jimenez EY, Lamers-Johnson E, Long JM, McCabe G, Ma X, Woodcock L, Bliss C, Abram JK, Steiber AL. Predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition indicators to diagnose malnutrition tool in hospitalized adults: a cohort study. Am J Clin Nutr. 2024; 119: 779– 787. doi: 10.1016/j.ajcnut.2023.12.012 38432715 source
plaincorrelationaln = 290- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Among older adults with HF, GLIM-defined malnutrition was linked to higher mortality independently of other prognostic factors and demonstrated better prognostic ability than the Geriatric Nutritional Risk Index (Table 2).7”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE
What the sources say
- Not checked yetcites [7] Hirose S, Matsue Y, Kamiya K, Kagiyama N, Hiki M, Dotare T, Sunayama T, Konishi M, Saito H, Saito K, Prevalence and prognostic implications of malnutrition as defined by GLIM criteria in elderly patients with heart failure. Clin Nutr. 2021; 40: 4334– 4340. doi: 10.1016/j.clnu.2021.01.014 33551220 source
Checked before — its earlier verdict is held back until a new check runs.
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not checked yet
None of the sources cited for this claim have been checked yet.
In the paper
“The pathophysiological basis of this catabolic state is thought to stem from complex interplay between the neurohormonal dysregulation of the advanced HF (particularly HF with reduced ejection fraction) syndrome, chronic inflammation, myocardial substrate demands of the failing heart, abnormalities of mesenteric perfusion,”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PATHOPHYSIOLOGY OF MALNUTRITION AND CACHEXIA IN INPATIENTS WITH CARDIAC CONDITIONS
What the sources say
- Not checked yetcites [90] Ilonze OJ, Parsly Read-Button L, Cogswell R, Hackman A, Breathett K, Saltzman E, Vest AR. Controversies and conundrums in cardiac cachexia: key questions about wasting in patients with HFrEF. JACC Heart Fail. 2024; 12: 1645– 1660. doi: 10.1016/j.jchf.2024.03.003 38727650 source
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In the paper
“Conversely, cardiac cachexia is characterized by a catabolic metabolism and accelerated turnover of protein stores, degrading fat-free mass and leading to elevated urine nitrogen excretion.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PATHOPHYSIOLOGY OF MALNUTRITION AND CACHEXIA IN INPATIENTS WITH CARDIAC CONDITIONS
What the sources say
- Not checked yetcites [90] Ilonze OJ, Parsly Read-Button L, Cogswell R, Hackman A, Breathett K, Saltzman E, Vest AR. Controversies and conundrums in cardiac cachexia: key questions about wasting in patients with HFrEF. JACC Heart Fail. 2024; 12: 1645– 1660. doi: 10.1016/j.jchf.2024.03.003 38727650 source
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In the paper
“Coenzyme Q10 supplementation has limited clinical trial support in patients with HF but has not been routinely adopted.112”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Not checked yetcites [112] Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart failure. 2014; 2: 641– 649. doi: 10.1016/j.jchf.2014.06.008 25282031 source
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In the paper
“Nutritional support plays a key role in the cardiac ICU (CICU), where malnutrition is frequently encountered.19”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS
What the sources say
- Not checked — no full text of the sourcecites [19] Frederiks P, Peetermans M, Wilmer A. Nutritional support in the cardiac intensive care unit. Eur Heart J Acute Cardiovasc Care. 2024; 13: 373– 379. doi: 10.1093/ehjacc/zuae018 38333990 source
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In the paper
“Therefore, current practice favors that adults with mild CKD (stages 1 and 2) should avoid >1.30 g·kg−1·d−1 protein intake and patients with CKD stages 3 to 5 not on dialysis are recommended to limit to 0.60 to 0.80 g·kg−1·d−1.127”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC INPATIENTS
What the sources say
- Not checked — no full text of the sourcecites [127] Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024; 105: S117– S314. doi: 10.1016/j.kint.2023.10.018 38490803 source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Moreover, their higher metabolic demand increases cardiac cachexia and sarcopenia risks, often coexisting with malnutrition and frailty, which negatively affects outcomes.19,90”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS
What the sources say
- Not checked — no full text of the sourcecites [19] Frederiks P, Peetermans M, Wilmer A. Nutritional support in the cardiac intensive care unit. Eur Heart J Acute Cardiovasc Care. 2024; 13: 373– 379. doi: 10.1093/ehjacc/zuae018 38333990 source
- Not checked yetcites [90] Ilonze OJ, Parsly Read-Button L, Cogswell R, Hackman A, Breathett K, Saltzman E, Vest AR. Controversies and conundrums in cardiac cachexia: key questions about wasting in patients with HFrEF. JACC Heart Fail. 2024; 12: 1645– 1660. doi: 10.1016/j.jchf.2024.03.003 38727650 source
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In the paper
“Similarly, the implementation of effective nutritional interventions also remains suboptimal, related to gaps in awareness among clinicians and insufficient integration of nutritional care into clinical CVD workflows.34”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > Abstract
What the sources say
- Not checked — no full text of the sourcecites [34] Uhl S, Siddique SM, Bloschichak A, McKeever W, D’Anci K, Leas B, Mull NK, Compher C, Lewis JD, Wu GD, Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis. J Hosp Med. 2022; 17: 556– 564. doi: 10.1002/jhm.12891 35729866 source
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In the paper
“The optimal protein intake for patients with cardiogenic shock is an area of ongoing research, with higher protein approaches not appearing beneficial in recent critical care trials.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > Abstract
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In the paper
“Patients admitted with HF to the CICU often have poor nutrient absorption from mucosal edema, low cardiac output, inflammation, and neurohormonal activation with mesenteric vasoconstriction and microvascular dysfunction.19”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Not checked — no full text of the sourcecites [19] Frederiks P, Peetermans M, Wilmer A. Nutritional support in the cardiac intensive care unit. Eur Heart J Acute Cardiovasc Care. 2024; 13: 373– 379. doi: 10.1093/ehjacc/zuae018 38333990 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Recognizing and differentiating between malnutrition, sarcopenia, and cachexia is clinically important because these conditions differ in their scope for reversibility and appropriate interventions.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DISTINCTIONS BETWEEN MALNUTRITION AND CACHEXIA, SARCOPENIA, AND FRAILTY
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In the paper
“It also underscores the significant impact of malnutrition on patient outcomes, including morbidity, mortality, and length of stay, as well as higher readmission rates and health care costs.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE
What the sources say
- Not checked — no full text of the sourcecites [35] Kootaka Y, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Nakamura T, Yamashita M, Maekawa E, Reed JL, Yamaoka-Tojo M, The GLIM criteria for defining malnutrition can predict physical function and prognosis in patients with cardiovascular disease. Clin Nutr. 2021; 40: 146– 152. doi: 10.1016/j.clnu.2020.04.038 32571679 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Further diagnostic challenges are posed by the International Classification of Disease, 9th Revision and current International Classification of Disease,10th Revision, which do not fully align with the diagnostic recommendations from these clinical practice guidelines. This has led to misalignment between academic constructs and billing codes that hampers educational efforts to raise awareness of”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DIAGNOSIS OF MALNUTRITION IN ACUTE CARDIAC CONDITIONS
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Refeeding syndrome can occur after prolonged starvation with aggressive oral feeding, EN, or parenteral nutrition (PN), and patients with mental health and substance use disorders, malabsorptive syndromes, surgeries, or vomiting are particularly at risk.133”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > General Principles
What the sources say
- Not checked — no full text of the sourcecites [133] da Silva JSV, Seres DS, Sabino K, Adams SC, Berdahl GJ, Citty SW, Cober MP, Evans DC, Greaves JR, Gura KM,; Parenteral Nutrition Safety and Clinical Practice Committees, American Society for Parenteral and Enteral Nutrition. ASPEN consensus recommendations for refeeding syndrome. Nutr Clin Pract. 2020; 35: 178– 195. doi: 10.1002/ncp.10474 32115791 source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is also increasingly recognized that malnutrition and skeletal muscle wasting commonly coexist in patients with obesity and that basing an assessment of nutritional status on weight or BMI is frequently misleading, especially among patients with CVD, who may experience alterations in extracellular fluid compartment volume.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > DIAGNOSIS OF MALNUTRITION IN ACUTE CARDIAC CONDITIONS
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In those cases, delayed EN (>48 hours) may be associated with better neurological outcomes,161 but this may simply reflect an immortal time bias.179”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in Cardiac Arrest in the CICU
What the sources say
- Not checked yetcites [161] Gutierrez A, Carlson C, Kalra R, Elliott AM, Yannopoulos D, Bartos JA. Outcomes associated with delayed enteral feeding after cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation and targeted temperature management. Resuscitation. 2021; 164: 20– 26. doi: 10.1016/j.resuscitation.2021.04.029 33965476 source
Checked before — its earlier verdict is held back until a new check runs.
- Not checked yetcites [179] Gutierrez A, Bartos JA. Reply to: immortal time bias in an observational study on enteral nutrition. Resuscitation. 2021; 166: 146– 147. doi: 10.1016/j.resuscitation.2021.07.032 34352332 source
Checked before — its earlier verdict is held back until a new check runs.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The primary composite end point of hypotension, aspiration pneumonia, hyperglycemia, and hypoglycemia occurred in 19.1% of the fasting group and 2.0% of the no-fasting group, with the analyses confirming noninferiority of no fasting (based on a noninferiority margin of 3% and a likelihood of 99.1%).182”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR PATIENTS UNDERGOING CARDIAC PROCEDURES > Cardiac Catheterization and Implantable Electronic Device Procedures
What the sources say
- Not checked yetcites [182] Ferreira D, Hardy J, Meere W, Butel-Simoes L, Sritharan S, Ray M, French M, McGee M, O’Connor S, Whitehead N, Fasting vs no fasting prior to catheterisation laboratory procedures: the SCOFF trial. Eur Heart J. 2024; 45: 4900– 4998. doi: 10.1093/eurheartj/ehae573 39217604 source
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plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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In the paper
“Evidence supporting prolonged preprocedural fasting for cardiac catheterization or implantation of electronic devices is weak, with no difference in gastric pH or volume between fasting 2 to 4 hours versus >4 hours.180,181”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR PATIENTS UNDERGOING CARDIAC PROCEDURES > Cardiac Catheterization and Implantable Electronic Device Procedures
What the sources say
- Not checked — no full text of the sourcecites [180] Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017; 126: 376– 393. doi: 10.1097/ALN.0000000000001452 28045707 source
- Not checked yetcites [181] Bangalore S, Barsness GW, Dangas GD, Kern MJ, Rao SV, Shore-Lesserson L, Tamis-Holland JE. Evidence-based practices in the cardiac catheterization laboratory: a scientific statement from the American Heart Association. Circulation. 2021; 144: e107– e119. doi: 10.1161/CIR.0000000000000996 34187171 source
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plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Early EN has also been shown to be safe in a prospective observational study with >200 patients with mechanical circulatory support,160 although that study excluded patients with refractory CS.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Not checked — no full text of the sourcecites [160] Flordelis Lasierra JL, Montejo Gonzalez JC, Lopez Delgado JC, Zarate Chug P, Martinez Lozano-Aranaga F, Lorencio Cardenas C, Bordeje Laguna ML, Maichle S, Terceros Almanza LJ, Trasmonte Martinez MV,; the NUTRIVAD Study Group. Enteral nutrition in critically ill patients under vasoactive drug therapy: the NUTRIVAD study. JPEN J Parenter Enteral Nutr. 2022; 46: 1420– 1430. doi: 10.1002/jpen.2371 35274345 source
plainn = 200- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“According to Enhanced Recovery After Surgery recommendations,186 perioperative nutritional optimization is key to expediting recovery.”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR PATIENTS UNDERGOING CARDIAC PROCEDURES > Cardiac Surgery
What the sources say
- Not checked yetcites [186] Engelman DT, Ben Ali W, Williams JB, Perrault LP, Reddy VS, Arora RC, Roselli EE, Khoynezhad A, Gerdisch M, Levy JH, Guidelines for perioperative care in cardiac surgery: Enhanced Recovery After Surgery society recommendations. JAMA Surg. 2019; 154: 755– 766. doi: 10.1001/jamasurg.2019.1153 31054241 source
Checked before — its earlier verdict is held back until a new check runs.
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
- Not checked yet
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“the risk of intestinal ischemia is higher for lactate >2.0159 or Sequential Organ Failure Assessment score >11.154”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
What the sources say
- Not checked — no full text of the sourcecites [159] Nuzzo A, Maggiori L, Ronot M, Becq A, Plessier A, Gault N, Joly F, Castier Y, Vilgrain V, Paugam C, Predictive factors of intestinal necrosis in acute mesenteric ischemia: prospective study from an intestinal stroke center. Am J Gastroenterol. 2017; 112: 597– 605. doi: 10.1038/ajg.2017.38 28266590 source
- Not checked — no full text of the sourcecites [154] Reignier J, Boisrame-Helms J, Brisard L, Lascarrou JB, Ait Hssain A, Anguel N, Argaud L, Asehnoune K, Asfar P, Bellec F,; NUTRIREA-2 Trial Investigators. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet. 2018; 391: 133– 143. doi: 10.1016/S0140-6736(17)32146-3 29128300 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Individualized RDN-led dietary counseling and support reduced the composite of hospital readmissions and mortality, as well as mortality as a secondary end point, and improved quality of life.132”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT AFTER DISCHARGE AND READMISSION REDUCTION
What the sources say
- Not checked — no full text of the sourcecites [132] Bonilla-Palomas JL, Gámez-López AL, Castillo-Domínguez JC, Moreno-Conde M, López Ibáñez MC, Alhambra Expósito R, Ramiro Ortega E, Anguita-Sánchez MP, Villar-Ráez A. Nutritional intervention in malnourished hospitalized patients with heart failure. Arch Med Res. 2016; 47: 535– 540. doi: 10.1016/j.arcmed.2016.11.005 28262195 source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Acutely decompensated cardiovascular disease often exacerbates pre-existing nutritional deficiencies, which in turn may worsen prognosis.
“Acutely decompensated CVD often exacerbates pre-existing nutritional deficiencies, which in turn may worsen prognosis, making timely identification and intervention critical yet challenging.”
The paper relies on this without support.
A focus on restrictive dietary counseling across cardiometabolic conditions may prompt excessively restrictive eating patterns that risk exacerbating micronutrient deficiencies and inadequacy of protein-calorie intake.
“However, the focus on restrictive dietary counseling across the cardiometabolic conditions, whether for sodium in populations with HF, sugars for those with diabetes, saturated fats for those with coronary artery disease, or caloric restriction for those with obesity, may prompt excessively restrictive eating patterns that risk exacerbating micronutrient deficiencies and inadequacy of protein-cal”
The paper relies on this without support.
Nil per os orders are a potential threat to adequate macronutrient intake for patients with cardiac conditions.
“Another potential threat to adequate macronutrient intake for patients with cardiac conditions is NPO orders, often used in preparation for procedures or because of concern for aspiration risks.”
The paper relies on this without support.
The risks of undernutrition are high in critically ill patients.
“For critically ill patients, the risks of undernutrition are high.”
The paper relies on this without support.
The prevalence of malnutrition lies between 20% and 60% in hospitalized patients with cardiovascular conditions.
“The prevalence of malnutrition lies between 20% and 60% in this population, with risk factors including age, comorbidities, metabolic demands, and inflammation and health care factors such as inpatient food choices and NPO times.”
The paper relies on this without support.
The GLIM criteria are the cornerstone of malnutrition diagnosis.
“The GLIM criteria are the cornerstone of malnutrition diagnosis.”
The paper relies on this without support.
Poor tolerance of enteral nutrition can be due to higher fat and higher fiber formulations.
“Poor tolerance of EN can be due to higher fat and higher fiber formulations, which are often problematic for critically ill patients.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > PREVALENCE AND CONSEQUENCES OF MALNUTRITION IN ACUTE CARDIOVASCULAR CARE
“The Agency for Healthcare Research and Quality report on malnutrition in hospitalized adults highlights the critical need for improved identification and management of malnutrition in clinical settings.35”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > References
“35. Kootaka Y, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Nakamura T, Yamashita M, Maekawa E, Reed JL, Yamaoka-Tojo M, The GLIM criteria for defining malnutrition can predict physical function and prognosis in patients with cardiovascular disease.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > NUTRITIONAL SUPPORT FOR CARDIAC CRITICAL CARE INPATIENTS > Nutritional Support in HF and Cardiogenic Shock in the CICU
“Another trial compared patients with shock receiving early (<24 hours) low-calorie (6 kcal·kg−1·d−1), low-protein (0.2–0.4 g/kg) EN with those receiving normocaloric (20–25 kcal·kg−1·d−1), normoproteic (1.0–1.3 g/kg) EN, including ≈18% with CS.155”
§ Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association > References
“[155] Landais M, Nay MA, Auchabie J, Hubert N, Frerou A, Yehia A, Mercat A, Jonas M, Martino F, Moriconi M,; REVA Network and CRICS-TriggerSEP F-CRIN Research Network. Continued enteral nutrition until extubation compared with fasting before extubation in patients in the intensive care unit: an open-label, cluster-randomised, parallel-group, non-inferiority trial.”
Citations
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Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment
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Metadata
- Authors
- Vest, A. R., DiDomenico, R. J., Lichtenstein, L., Slater, T., Ekpo, E., Damluji, A. A., Bohula, E., Alviar, C. L., on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology, & Council on Cardiovascular and Stroke Nursing
- Venue
- Circulation
- Published
- 2026-03-31
- Volume
- 153
- Issue
- 13
- Pages
- e1078-e1105
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC13250749
- OpenAlex
- W7131299326
- Semantic Scholar
- 2b697746bef794cfae41a96460c606b4809282a5
- Cited by
- 15
- References
- 219
- Citations by year
- 2026: 15
- FWCI
- 61.75
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Funders
- National Institutes of Health (5k23hl153771-05)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- malnutrition, cachexia, acute coronary syndrome, cardiac arrhythmias, valvular heart disease, heart failure, nutritional support, enteral nutrition, parenteral nutrition, cardiogenic shock, protein intake, mortality, length of hospital stay, GLIM, hospitalized patients
- MeSH terms
- Acute Disease, American Heart Association, Cachexia, Enteral Nutrition, Heart Diseases, Hospitalization, Humans, Inpatients, Parenteral Nutrition, United States, Nutritional Support, Malnutrition
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-20, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-20 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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