Prognostic Nutritional Index as a New Prediction Tool for Coronary Collateral Development

Acta Cardiol Sin. 2022 Jan;38(1):21-26. doi: 10.6515/ACS.202201_38(1).20210906A.

Abstract

Background: Nutritional status is a predictor of the prognosis of cardiovascular diseases. The association between the Prognostic Nutritional Index (PNI), which is an immunonutritional parameter, and cardiovascular diseases has been extensively studied in the literature.

Objectives: The aim of this study was to investigate whether PNI is associated with coronary collateral development.

Methods: This retrospective study included 172 patients with chronic total occlusion. The patients were diagnosed with stable coronary artery disease, and all patients underwent coronary angiography. PNI was calculated using serum albumin level and lymphocyte count. Collateral circulation was classified according to Rentrop grade.

Results: There was a positive correlation between PNI and Rentrop grade (r = 0.168, p = 0.026) and a negative correlation between C-reactive protein and PNI (r = -0.353, p < 0.001). Multivariate logistic regression analysis showed that uric acid and PNI were independent predictors of Rentrop grade (p = 0.008 and p = 0.037, respectively).

Conclusions: This study showed that PNI, which can easily be calculated using serum albumin level and lymphocyte count, was a predictor of coronary collateral development in terms of Rentrop grade.

Keywords: Chronic total occlusion; Coronary collateral; Inflammation; Prognostic Nutritional Index.