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GNRI和TyG指数对非ST段抬高型急性冠脉综合征患者PCI术后预后不良的预测价值。

Predictive value of GNRI and TyG index for poor prognosis in NSTE-ACS patients post-PCI.

作者信息

Xia Siliang, Liu Dandan, Liu Yun, Zhang Xiaobing, Zhang Xiangming

机构信息

Department of Cardiology, Nanjing Jiangbei Hospital, Nanjing, China.

Department of Cardiology, Nanjing Jiangbei Hospital, Nanjing, China. Email:

出版信息

Asia Pac J Clin Nutr. 2025 Jun;34(3):440-450. doi: 10.6133/apjcn.202506_34(3).0018.

Abstract

BACKGROUND AND OBJECTIVES

This study aimed to assess the predictive power of the Geriatric Nutritional Risk Index (GNRI) and the triglyceride-glucose (TyG) index for poor prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients post-percutaneous coronary intervention (PCI).

METHODS AND STUDY DESIGN

A cohort of 393 NSTE-ACS patients who underwent PCI at the People's Hospital of Nanjing Jiangbei from 2016 to 2022 was analyzed. Major adverse cardiovascular events (MACEs), including death, non-fatal myocardial infarction, and target vessel revascularization, served as the primary outcome. Relationships between GNRI, TyG index, and MACEs were explored using univariate and multivariate logistic regres-sion, with results presented as odds ratios (OR) and 95% confidence intervals (CI). The predictive value was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve.

RESULTS

MACEs occurred in 34 patients. A TyG index ≥1.36 was associated with a significantly increased risk of MACEs (OR=5.07, 95%CI: 1.64-15.71), while a GNRI ≥108 indicated a decreased risk (OR=0.17, 95%CI: 0.04-0.68). These associations were consistent across various subgroups, including age, gender, and specific pre-existing conditions. The combined predictive value of TyG index and GNRI was higher than each alone (AUC=0.711, 95%CI: 0.642-0.779).

CONCLUSIONS

In post-PCI patients with NSTE-ACS, the TyG index and GNRI are significant predictors of MACEs, with the TyG index indicating higher risk and GNRI lower risk. Their combined use may enhance the predictive accuracy for MACEs in this patient population.

摘要

背景与目的

本研究旨在评估老年营养风险指数(GNRI)和甘油三酯-葡萄糖(TyG)指数对非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)后预后不良的预测能力。

方法与研究设计

分析了2016年至2022年在南京江北人民医院接受PCI的393例NSTE-ACS患者队列。主要不良心血管事件(MACE),包括死亡、非致命性心肌梗死和靶血管血运重建,作为主要结局。使用单因素和多因素逻辑回归探索GNRI、TyG指数与MACE之间的关系,结果以比值比(OR)和95%置信区间(CI)表示。使用受试者工作特征(ROC)曲线的曲线下面积(AUC)进一步评估预测价值。

结果

34例患者发生了MACE。TyG指数≥1.36与MACE风险显著增加相关(OR=5.07,95%CI:1.64-15.71),而GNRI≥108表明风险降低(OR=0.17,95%CI:0.04-0.68)。这些关联在包括年龄、性别和特定既往疾病在内的各个亚组中都是一致的。TyG指数和GNRI的联合预测价值高于单独使用时(AUC=0.711,95%CI:0.642-0.779)。

结论

在NSTE-ACS的PCI术后患者中,TyG指数和GNRI是MACE的重要预测指标,TyG指数表明风险较高,GNRI表明风险较低。它们的联合使用可能会提高该患者群体中MACE的预测准确性。

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