A novel and useful predictive indicator of prognosis in ST-segment elevation myocardial infarction, the prognostic nutritional index

Nutr Metab Cardiovasc Dis. 2017 May;27(5):438-446. doi: 10.1016/j.numecd.2017.01.005. Epub 2017 Jan 18.

Abstract

Background and aim: The prognostic impact of poor nutritional status and cardiac cachexia in myocardial infarction is not clearly understood. Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in colorectal surgeries and postoperative septic complications. The present study aimed to evaluate the prognostic value of PNI in ST-segment elevation myocardial infarction (STEMI) patients.

Methods and results: We evaluated the in-hospital and long-term (3 years) prognostic impact of PNI on 1823 patients with STEMI undergoing primary percutaneous coronary intervention. Patients with lower PNI had significantly higher in-hospital and long-term mortality and major adverse cardiac events. After adjustment for all confounders, the in-hospital mortality rates were 7.9 times higher at the lower PNI level (95% CI: 5.0-15.8) than those at the higher PNI level. The long-term mortality rates were also 6.4 times higher at the lower PNI level (95% CI: 4.4-12.4) than those at the higher PNI level.

Conclusion: The present study demonstrated that the PNI, calculated based on the serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with STEMI.

Keywords: Mortality; Myocardial infarction; Prognosis; Prognostic nutritional index.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Area Under Curve
  • Biomarkers / blood
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Male
  • Malnutrition / blood
  • Malnutrition / diagnosis*
  • Malnutrition / mortality
  • Malnutrition / physiopathology
  • Middle Aged
  • Nutrition Assessment*
  • Nutritional Status*
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / mortality
  • Pilot Projects
  • Predictive Value of Tests
  • Proportional Hazards Models
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Serum Albumin / analysis
  • Serum Albumin, Human
  • Time Factors
  • Turkey

Substances

  • ALB protein, human
  • Biomarkers
  • Serum Albumin
  • Serum Albumin, Human