Your new experience awaits. Try the new design now and help us make it even better

SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.

Sec. Heart Failure and Transplantation

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1665713

This article is part of the Research TopicNew Insights into the Pathogenesis, Diagnosis and Therapy of Chronic Heart Failure in Nonischemic CardiomyopathiesView all 5 articles

Association between Controlling Nutritional Status score and the prognosis of patients with heart failure: a systematic review and meta-analysis

Provisionally accepted
  • The Second Clinical Medical College of North Sichuan Medical College, Nanchong, China

The final, formatted version of the article will be published soon.

Background: Malnutrition frequently complicates heart failure (HF), interacting with systemic inflammation, metabolic dysregulation, and immune dysfunction to accelerate disease progression. The Controlling Nutritional Status (CONUT) score, derived from objective laboratory parameters (serum albumin, total cholesterol, lymphocyte count), quantifies nutritional derangements and has emerged as a promising tool for HF risk stratification and prognostic prediction. However, accumulating evidence requires systematic synthesis to establish its clinical validity. Methods: A comprehensive literature search was conducted in databases including PubMed, Embase, the Cochrane Library and Web of Science, covering all available records up to January 27, 2025, to identify research examining the association between the CONUT score and HF outcomes. Results: The analysis included 28 cohort studies. Pooled data demonstrated a significant correlation between elevated CONUT scores and higher rates of all-cause mortality (HR = 1.57, 95% CI 1.35– 1.83; P < 0.00001). Despite substantial heterogeneity, sequential exclusion sensitivity analyses confirmed the robustness of this association, with recalculated estimates consistently showing overlapping confidence intervals across all analytical scenarios. Conclusion: Based on the definition of the CONUT score, malnutrition remains a significant factor associated with overall mortality risk in individuals diagnosed with heart failure, even after controlling for potential confounders. Utilizing the CONUT score for nutritional assessment enables clinicians to detect patients who are more likely to experience unfavorable clinical outcomes. Systematic review registration: PROSPERO, identifier CRD420251023217

Keywords: CONUT1, Heart Failure2, prognosis3, malnutrition4, all-cause mortality5

Received: 14 Jul 2025; Accepted: 30 Sep 2025.

Copyright: © 2025 Yuan, Wang, Yi, Yang, Zhong and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Haoyu Wang, 361536712@qq.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.