Prognostic impacts of geriatric nutritional risk index in patients with ischemic heart failure after percutaneous coronary intervention

医学 四分位间距 狼牙棒 经皮冠状动脉介入治疗 内科学 四分位数 临床终点 传统PCI 心肌梗塞 比例危险模型 心脏病学 心力衰竭 入射(几何) 对数秩检验 置信区间 随机对照试验 光学 物理
作者
Tienan Sun,Meishi Ma,Xin Huang,Biyang Zhang,Zheng Chen,Zehao Zhao,Yujie Zhou
出处
期刊:Clinical Nutrition [Elsevier BV]
卷期号:42 (8): 1260-1267 被引量:15
标识
DOI:10.1016/j.clnu.2023.05.023
摘要

Malnutrition has been proven to be associated with increased risk of poor prognosis in a series of diseases. This study explored the association between poor nutritional status and prognosis in patients with ischemic heart failure (IHF) undergoing percutaneous coronary intervention (PCI).The study enrolled 1745 patients with IHF undergoing PCI. The mean follow-up time was 28.7 months. Nutritional status was assessed by geriatric nutritional risk index (GNRI). All patients were divided into four groups according to GNRI quartiles (median and interquartile range: 103.8, 99.9-107.7). The primary endpoint was major adverse cardiovascular events (MACE), and the secondary endpoints were each component of the primary endpoint as follows: all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. The Kaplan-Meier survival analyses were performed to evaluate the incidence of the endpoints among 4 groups. The multivariate Cox proportional hazards analysis confirmed the independent effect of GNRI on the primary endpoint and secondary endpoints. The restricted cubic spline (RCS) was performed to evaluate the non-linear association of GNRI with MACE.The negative correlation of the GNRI with MACE (Log-rank P < 0.001), all-cause mortality (Log-rank P < 0.001) and any revascularization (Log-rank P < 0.001) was confirmed through the Kaplan-Meier curves. Multivariate analysis showed that the decreased GNRI was independently related to increased risk of MACE (Quartile 1 versus Quartile 4: HR, 95% CI: 2.66, 2.01-3.51, P < 0.001), all-cause mortality (Quartile 1 versus Quartile 4: HR, 95% CI: 2.33, 1.54-3.50, P < 0.001) and any revascularization (Quartile 1 versus Quartile 4: HR, 95% CI: 3.42, 2.22-5.27, P < 0.001). In addition, the non-linear association of GNRI with MACE was shown through RCS and the risk of MACE decreased as the GNRI increased in general (Non-linear P < 0.001).Decreased GNRI was an independent risk factor of MACE in IHF patients undergoing PCI.
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