Tolunay Hatice, Yasar Salim, Asil Serkan, Yildirim Erkan, Yasar Ayse Saatci, Celik Murat, Yuksel Uygar Cagdas, Barcin Cem
Department of Cardiology, Gulhane Training and Research Hospital, Ankara, Turkey.
Acta Cardiol Sin. 2022 May;38(3):362-372. doi: 10.6515/ACS.202205_38(3).20211222A.
The prognostic importance of nutritional indexes has been shown in some diseases. We aimed to examine the prognostic value of these indexes in patients implanted with the Carillon Mitral Contour System (CMCS).
Fifty-four patients who underwent successful CMCS implantation were evaluated. Prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) scores were calculated. The relationships between these indexes and 1-year clinical outcomes including all-cause mortality and re-hospitalization due to heart failure were investigated.
In Kaplan-Meier analysis, 1-year all-cause mortality rates were significantly higher in the patients with low PNI and GNRI and high CONUT scores (52.0% vs. 0%, p < 0.001; 54.2% vs. 0%, p < 0.001; 52.4%, 6.1%, p < 0.001; respectively). For the composite endpoint, a significant difference was observed between those below and above the cut-off values (70.0% vs. 16.7%, p < 0.001; 75.0% vs. 23.3%, p < 0.001; 66.7% vs. 20.8%, p < 0.001, respectively). In multivariate Cox regression analysis, GNRI was determined to be an independent predictor of 1-year all-cause mortality [hazard ratio: 0.707; 95% confidence interval: 0.510-0.979; p = 0.037].
Nutritional indexes have prognostic value in predicting 1-year all-cause mortality in severe functional mitral regurgitation patients undergoing CMCS implantation. In particular, GNRI can guide the selection of patients who will benefit from CMCS.
营养指标的预后重要性已在一些疾病中得到证实。我们旨在研究这些指标在植入Carillon二尖瓣轮廓系统（CMCS）的患者中的预后价值。
对54例成功植入CMCS的患者进行评估。计算预后营养指数（PNI）、老年营养风险指数（GNRI）和控制营养状况（CONUT）评分。研究这些指标与包括全因死亡率和因心力衰竭再次住院在内的1年临床结局之间的关系。
在Kaplan-Meier分析中，PNI和GNRI较低且CONUT评分较高的患者1年全因死亡率显著更高（分别为52.0%对0%，p<0.001；54.2%对0%，p<0.001；52.4%对6.1%，p<0.001）。对于复合终点，在临界值以下和以上的患者之间观察到显著差异（分别为70.0%对16.7%，p<0.001；75.0%对23.3%，p<0.001；66.7%对20.8%，p<0.001）。在多变量Cox回归分析中，GNRI被确定为1年全因死亡率的独立预测因子[风险比：0.707；95%置信区间：0.510-0.979；p=0.037]。
营养指标在预测接受CMCS植入的严重功能性二尖瓣反流患者的1年全因死亡率方面具有预后价值。特别是，GNRI可以指导选择将从CMCS中获益的患者。
