一种用于ST段抬高型心肌梗死预后的新型且有用的预测指标——预后营养指数。

A novel and useful predictive indicator of prognosis in ST-segment elevation myocardial infarction, the prognostic nutritional index.

作者信息

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

机构信息

Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.

出版信息

Nutr Metab Cardiovasc Dis. 2017 May;27(5):438-446. doi: 10.1016/j.numecd.2017.01.005. Epub 2017 Jan 18.

DOI:10.1016/j.numecd.2017.01.005

PMID:28392077

Abstract

BACKGROUND AND AIM

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.

METHODS AND RESULTS

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.

CONCLUSION

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.

摘要

背景与目的

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。

方法与结果

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）。