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经皮冠状动脉介入治疗的急性冠状动脉综合征患者的营养状况及预后意义。

Prevalence and prognostic significance of malnutrition in patients with acute coronary syndrome treated with percutaneous coronary intervention.

机构信息

Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

出版信息

Medicine (Baltimore). 2022 Aug 26;101(34):e30100. doi: 10.1097/MD.0000000000030100.

Abstract

The incidence and impact of malnutrition on acute coronary syndrome (ACS) remain unclear. This study aimed to evaluate the prevalence, clinical relevance, and prognostic outcomes of malnutrition in patients with ACS treated with percutaneous coronary intervention. This retrospective study included 1930 consecutive patients with ACS undergoing percutaneous coronary intervention and assessed their nutritional status using 3 scoring systems: Controlling Nutritional Status score, nutritional risk index (NRI), and prognostic nutritional index (PNI). The primary endpoint was all-cause mortality. The Controlling Nutritional Status, NRI, and PNI scores showed that 5.2%, 17.5%, and 3.9% of patients were moderately or severely malnourished, respectively. During a median follow-up of 67.2 months (interquartile range: 46.8-88.5 months), 74 (3.8%) patients died. Malnutrition was associated with a significantly increased risk for all-cause mortality compared with good nutrition (adjusted hazard ratios for moderate and severe malnutrition, respectively: 5.65 [95% confidence interval: 3.27-9.78] and 15.26 [7.50-31.05] for the NRI score, 5.53 [2.10-14.49] and 11.08 [5.69-21.59] for the PNI; P < .001). The current findings demonstrated that malnutrition is prevalent among patients with ACS and is closely associated with increased mortality. Further study is needed to evaluate the effects of nutritional interventions on the outcomes of patients with ACS.

摘要

营养不良对急性冠状动脉综合征(ACS)的发生和影响仍不清楚。本研究旨在评估经皮冠状动脉介入治疗的 ACS 患者营养不良的患病率、临床相关性和预后结局。本回顾性研究纳入了 1930 例连续接受经皮冠状动脉介入治疗的 ACS 患者,并使用 3 种评分系统评估其营养状况:控制营养状况评分、营养风险指数(NRI)和预后营养指数(PNI)。主要终点为全因死亡率。控制营养状况评分、NRI 和 PNI 评分显示,分别有 5.2%、17.5%和 3.9%的患者存在中重度营养不良。在中位数为 67.2 个月(四分位距:46.8-88.5 个月)的随访期间,74 例(3.8%)患者死亡。与营养良好相比,营养不良与全因死亡率显著增加相关(中重度营养不良的校正风险比分别为:5.65[95%置信区间:3.27-9.78]和 15.26[7.50-31.05],NRI 评分;5.53[2.10-14.49]和 11.08[5.69-21.59],PNI;P<0.001)。目前的研究结果表明,ACS 患者中营养不良很常见,且与死亡率增加密切相关。需要进一步研究评估营养干预对 ACS 患者结局的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c79/9410591/6b06dbde460a/medi-101-e30100-g001.jpg

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