Özkan Can, Dolu Abdullah Kadir, Çelik Muhammet Cihat, Demirtaş Bekir, Karayiğit Orhan
Department of Cardiology, Bursa City Hospital, Bursa, Türkiye.
Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye.
Anatol J Cardiol. 2024 Nov 25;29(1):19-25. doi: 10.14744/AnatolJCardiol.2024.4407.
Coronary artery disease (CAD) is a widespread health issue globally, linked to significant morbidity and mortality. While oxidative stress, dysregulated lipid metabolism, and unhealthy lifestyle choices contribute to CAD, recent research highlights the role of immune responses and inflammation. Malnutrition, a modifiable risk factor, notably impacts CAD prognosis. The prognostic nutritional index (PNI), derived from serum albumin and lymphocyte count, predicts outcomes in various diseases. This study aims to elucidate the relationship between malnutrition, as assessed by the PNI score, and the functional significance of coronary artery stenosis, evaluated by fractional flow reserve (FFR) measurements.
A retrospective analysis involved 232 patients with single intermediate-grade coronary stenosis who underwent FFR measurement between January 2022 and January 2024. Prognostic nutritional index values were calculated from serum albumin and lymphocyte counts. Patients were divided into 2 groups based on FFR values.
Patients with hemodynamically significant coronary stenosis (FFR ≤ 0.80) exhibited higher inflammatory markers and triglycerides, while those with FFR > 0.80 showed elevated albumin and PNI levels. Triglycerides and PNI emerged as independent predictors of significant coronary stenosis.
This study demonstrates that PNI is independently associated with the functional significance of coronary artery stenosis as determined by FFR. Since lymphocytes, total protein and albumin values, which are readily available from routine blood tests, form the basis for PNI, this index can be easily used in clinical settings to predict hemodynamically significant coronary artery stenosis. However, the results of this study should be further expanded and validated through studies involving larger samples and prospective designs.
冠状动脉疾病（CAD）是全球广泛存在的健康问题，与高发病率和死亡率相关。虽然氧化应激、脂质代谢失调和不健康的生活方式选择会导致CAD，但最近的研究突出了免疫反应和炎症的作用。营养不良是一个可改变的风险因素，对CAD预后有显著影响。预后营养指数（PNI）由血清白蛋白和淋巴细胞计数得出，可预测多种疾病的预后。本研究旨在阐明通过PNI评分评估的营养不良与通过血流储备分数（FFR）测量评估的冠状动脉狭窄功能意义之间的关系。
一项回顾性分析纳入了232例在2022年1月至2024年1月期间接受FFR测量的单支中度冠状动脉狭窄患者。根据血清白蛋白和淋巴细胞计数计算预后营养指数值。根据FFR值将患者分为两组。
血流动力学上有显著冠状动脉狭窄（FFR≤0.80）的患者炎症标志物和甘油三酯水平较高，而FFR>0.80的患者白蛋白和PNI水平升高。甘油三酯和PNI是显著冠状动脉狭窄的独立预测因素。
本研究表明，PNI与通过FFR确定的冠状动脉狭窄功能意义独立相关。由于淋巴细胞、总蛋白和白蛋白值可从常规血液检查中轻易获得，它们构成了PNI的基础，该指数可在临床环境中轻松用于预测血流动力学上有显著意义的冠状动脉狭窄。然而，本研究结果应通过涉及更大样本和前瞻性设计的研究进一步扩展和验证。
