Keskin M, Hayıroğlu M I, Keskin T, Kaya A, Tatlısu M A, Altay Servet, Uzun A O, Börklü E B, Güvenç T S, Avcı I I, Kozan Ö
Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Nutr Metab Cardiovasc Dis. 2017 May;27(5):438-446. doi: 10.1016/j.numecd.2017.01.005. Epub 2017 Jan 18.
The prognostic impact of poor nutritional status and cardiac cachexia in myocardial infarction is not clearly understood. Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in colorectal surgeries and postoperative septic complications. The present study aimed to evaluate the prognostic value of PNI in ST-segment elevation myocardial infarction (STEMI) patients.
We evaluated the in-hospital and long-term (3 years) prognostic impact of PNI on 1823 patients with STEMI undergoing primary percutaneous coronary intervention. Patients with lower PNI had significantly higher in-hospital and long-term mortality and major adverse cardiac events. After adjustment for all confounders, the in-hospital mortality rates were 7.9 times higher at the lower PNI level (95% CI: 5.0-15.8) than those at the higher PNI level. The long-term mortality rates were also 6.4 times higher at the lower PNI level (95% CI: 4.4-12.4) than those at the higher PNI level.
The present study demonstrated that the PNI, calculated based on the serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with STEMI.
心肌梗死患者营养状况不佳及心脏恶病质的预后影响尚不清楚。近期研究表明预后营养指数(PNI)在结直肠手术及术后感染并发症方面具有预后价值。本研究旨在评估PNI对ST段抬高型心肌梗死(STEMI)患者的预后价值。
我们评估了PNI对1823例行直接经皮冠状动脉介入治疗的STEMI患者的住院及长期(3年)预后影响。PNI较低的患者住院及长期死亡率和主要不良心脏事件显著更高。在对所有混杂因素进行校正后,PNI较低水平时的住院死亡率比PNI较高水平时高7.9倍(95%可信区间:5.0 - 15.8)。PNI较低水平时的长期死亡率也比PNI较高水平时高6.4倍(95%可信区间:4.4 - 12.4)。
本研究表明,基于血清白蛋白水平和淋巴细胞计数计算的PNI是STEMI患者死亡率的独立预后因素。