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预后营养指数作为接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者无复流发生的预测指标

Prognostic Nutritional Index as a Predictor of No-Reflow Occurrence in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention.

作者信息

Safak Ozgen, Yildirim Tarik, Emren Volkan, Avci Eyup, Argan Onur, Aktas Zihni, Yildirim Seda Elcim, Akgun Didar Elif, Kisacik Halil Lutfi

机构信息

Department of Cardiology, Balıkesir University, Balıkesir, Turkey.

Department of Cardiology, İzmir Katip Çelebi University, İzmir, Turkey.

出版信息

Angiology. 2024 Aug;75(7):689-695. doi: 10.1177/00033197231193223. Epub 2023 Aug 8.

Abstract

Nutritional status and its index (Prognostic Nutritional Index, PNI) is an important prognostic factor for ST-segment elevation myocardial infarction (STEMI). The present study investigated whether PNI it is associated with no-reflow in patients with STEMI. In this retrospective study, 404 patients with STEMI and underwent primary percutaneous coronary intervention (pPCI) were consecutively included, between January 2016 and December 2018. No-reflow phenomenon (NRP) was detected in 103 (25.4%) patients. In multivariate logistic regression analysis C-reactive protein (CRP) (odds ratio (OR): 1.693, 95% confidence interval (CI): 1.126-2.547, = .011), left ventricle ejection fraction (LVEF) (OR: 0.777, 95% CI: 0.678-0.891, < .001), SYNTAX score (OR: 1.114, 95% CI: 1.050-1.183, = .001), low density lipoprotein cholesterol (LDL-C) (OR: 1.033, 95% CI: 1.013-1.055, = .002), hemoglobin level (OR: 0.572, 95% CI: 0.395-0.827, = .003), PNI (OR: 0.554, 95% CI: 0.448-0.686, < .001) were associated with NRP. The area under curve of PNI was significantly higher than albumin (z = 4.747, < .001) and lymphocyte values (z = 3.481 < .001). PNI was associated with no-reflow occurrence and mortality. So, PNI may be useful to predict NRP risk in patients with STEMI before pPCI.

摘要

营养状况及其指标(预后营养指数,PNI)是ST段抬高型心肌梗死(STEMI)的重要预后因素。本研究调查了PNI是否与STEMI患者的无复流相关。在这项回顾性研究中,连续纳入了2016年1月至2018年12月期间404例接受直接经皮冠状动脉介入治疗(pPCI)的STEMI患者。103例(25.4%)患者检测到无复流现象(NRP)。在多因素逻辑回归分析中,C反应蛋白(CRP)(比值比(OR):1.693,95%置信区间(CI):1.126 - 2.547,P = .011)、左心室射血分数(LVEF)(OR:0.777,95% CI:0.678 - 0.891,P < .001)、SYNTAX评分(OR:1.114,95% CI:1.050 - 1.183,P = .001)、低密度脂蛋白胆固醇(LDL-C)(OR:1.033,95% CI:1.013 - 1.055,P = .002)、血红蛋白水平(OR:0.572,95% CI:0.395 - 0.827,P = .003)、PNI(OR:0.554,95% CI:0.448 - 0.686,P < .001)与NRP相关。PNI的曲线下面积显著高于白蛋白(z = 4.747,P < .001)和淋巴细胞值(z = 3.481,P < .001)。PNI与无复流的发生和死亡率相关。因此,PNI可能有助于预测STEMI患者在pPCI前发生NRP的风险。

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