Combined effects of nutritional status on long-term mortality in patients with non-st segment elevation myocardial infarction undergoing percutaneous coronary intervention

Abstract

OBJECTIVE:The aim of this study was to investigate the performance of controlling nutritional status (CONUT) index, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI) scores in predicting the long-term prognosis of patients with non-ST-elevated myocardial infarction (NSTEMI) who underwent percutaneous coronary intervention (PCI). METHODS: A total of 915 patients with NSTEMI (female: 48.4%; mean age: 73.1±9.0 years) who underwent PCI at Adana Numune Training and Research Hospital, Cardiology Clinic between January 2014 and January 2015 were included in this cross-sectional and retrospective study. CONUT, GNRI, and PNI scores were calculated based on the admission data derived from samples of peripheral venous blood. The mean follow-up duration was 64.5±15.4 months. RESULTS:During follow-up (mean 64.5±15.4 months), 179 patients (19.6%) died. The mean GNRI and PNI scores were significantly lower in the nonsurvivor group; however, the median CONUT score was significantly higher in the nonsurvivor group compared with the survivor group. The receiver operating characteristic (ROC) curve analyses have shown that GNRI score has similar performance to the CONUT score and has better performance than PNI score in predicting 5-year mortality. The Kaplan-Meier curve analysis has shown that patients with lower PNI or GNRI had higher cumulative mortality than the patients with higher PNI or GNRI. Also, the patients with higher CONUT scores had higher cumulative mortality compared with those with lower scores. The multivariate analyses have shown that GNRI (HR: 0.973), PNI (HR: 0.967), CONUT score (HR: 1.527), and body mass index (BMI) (HR: 0.818) were independent predictors of the 5-year mortality in patients with NSTEMI. CONCLUSION:In this study, we have shown that CONUT score, GNRI, and PNI values were associated with the long-term mortality in patients with NSTEMI who underwent PCI, and GNRI yielded similar results to CONUT score but was better than PNI.

Geriatric nutritional risk index predicts all-cause mortality in the oldest-old patients with acute coronary syndrome: A 10-year cohort study

“…These methods are sensitive to subjective biases and have limitations in terms of time, personnel, and the potential for overdiagnosis. Several studies have compared GNRI with them ( 40 , 41 ). Wafaa et al ( 25 ) demonstrated that GNRI had a stronger predictive value for describing and classifying nutritional status and nutritional-related problems in elderly hospitalized patients.…”

Relationship Between Prognostic Nutritional Index and Contrast-Associated Acute Kidney Injury in Patients With Non-ST Segment Elevation Myocardial Infarction Undergoing Coronary Angiography

“…11 In a study in which long-term prognosis was evaluated in NSTEMI patients who underwent PCI, PNI was an independent predictor for 5-year mortality. 26…”

Cut-off values of geriatric nutritional risk index for cardiovascular events in acute myocardial infarction patients

“…Low GNRI in heart failure, cancer and other heart disease, such as aortic stenosis has been reported to be associated with a poor prognosis [6][7][8][9][10][11]. Several studies and meta-analyses have reported that low GNRI in ischemic heart disease (IHD) was correlated with increased all-cause death and cardiovascular events [12][13][14][15][16]. In contrast, some studies have reported that GNRI is not associated with increased cardiovascular events in acute myocardial infarction (AMI) [17,18].…”