Kucukosmanoglu Mehmet, Yildirim Arafat, Yavuz Fethi, Dogdus Mustafa, Kilic Salih
Saglik Bilimleri University, Adana City Training and Research Hospital, Department of Cardiology, Adana, Turkey.
Usak University, Training and Research Hospital, Department of Cardiology, Usak, Turkey.
Medeni Med J. 2020;35(1):47-54. doi: 10.5222/MMJ.2020.86094. Epub 2020 Feb 28.
Geriatric nutritional risk index (GNRI) is a useful tool to determine the nutritional status of patients. Any study has not evaluated the impact of GNRI in development of contrast- induced nephropathy (CIN) after percutaneous coronary intervention (PCI). We aimed to evaluate whether GNRI could predict CIN after PCI.
A total of 1116 patients with non-ST elevation myocardial infarction (non-STEMI) that underwent PCI were enrolled to the present study. The GNRI was calculated using a previously reported formula: GNRI=14.89 × albumin (g/dL) + 41.7 × body weight (kg)/ideal body weight (kg). CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after the PCI procedure. The patients were categorized into two groups as CIN (+) and CIN (-).
The mean age of the CIN (+) group was significantly higher than the CIN (-) group (64.8±10.67 vs. 60.5±10.61 years; p<0.001). The mean values of height, weight, and body mass index were significanlty lower in CIN (+) group than CIN (-) group (p<0.001, for all). The mean of GNRI was significantly lower in the CIN (+) group than the CIN (-) group (101.4±8.7 vs. 112.1±12.9; p<0.001). Serum albumin level was significantly lower in the CIN (+) group (3.71±0.52 g/dL vs. 3.94±0.53 g/dL; p<0.001). Left ventricular ejection fraction (LVEF) was significantly lower in the CIN (+) group (50.7%±9.07 vs. 54.3%±7.20; p<0.001).
In this study, GNRI, serum albumin level, BMI, and LVEF were independent predictors of CIN. Moreover, GNRI was better than both serum albumin level and BMI in predicting development of CIN.
老年营养风险指数（GNRI）是确定患者营养状况的一项有用工具。尚无研究评估GNRI对经皮冠状动脉介入治疗（PCI）后对比剂肾病（CIN）发生的影响。我们旨在评估GNRI是否能预测PCI术后的CIN。
本研究纳入了1116例行PCI的非ST段抬高型心肌梗死（非STEMI）患者。GNRI采用先前报道的公式计算：GNRI = 14.89×白蛋白（g/dL）+ 41.7×体重（kg）/理想体重（kg）。CIN定义为PCI术后72小时内血清肌酐水平升高≥0.5 mg/dL或高于基线水平≥25%。患者被分为CIN（+）和CIN（-）两组。
CIN（+）组的平均年龄显著高于CIN（-）组（64.8±10.67岁 vs. 60.5±10.61岁；p<0.001）。CIN（+）组的身高、体重和体重指数的平均值显著低于CIN（-）组（均p<0.001）。CIN（+）组的GNRI平均值显著低于CIN（-）组（101.4±8.7 vs. 112.1±12.9；p<0.001）。CIN（+）组的血清白蛋白水平显著较低（3.71±0.52 g/dL vs. 3.94±0.53 g/dL；p<0.001）。CIN（+）组的左心室射血分数（LVEF）显著较低（50.7%±9.07 vs. 54.3%±7.20；p<0.001）。
在本研究中，GNRI、血清白蛋白水平、BMI和LVEF是CIN的独立预测因素。此外，在预测CIN的发生方面，GNRI优于血清白蛋白水平和BMI。
