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

Keskin, Muhammed; Hayıroğlu, Mert İlker; Keskin, Taha; Kaya, Adnan; Tatlısu, Mustafa Adem; Altay, Servet; Uzun, Ahmet Okan; Börklü, Edibe Betül; Güvenç, Tolga Sinan; Avcı, İlhan İlker; Kozan, Ömer

doi:10.1016/j.numecd.2017.01.005

Cited by 74 publications

(74 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mortality in acute PE is strongly correlated with PNI score similar to myocardial infarction. 16,18 The decreased response of albumin and lymphocytes to acute disease indicates low immune-nutritional status. Therefore, the PNI score should be considered as a clinical element and indicator of disease severity in acute PE.…”

Section: Discussionmentioning

confidence: 99%

A Novel Independent Survival Predictor in Pulmonary Embolism: Prognostic Nutritional Index

Hayıroğlu

Keskin

et al. 2017

Clin Appl Thromb Hemost

Self Cite

View full text Add to dashboard Cite

The prognostic impact of nutritional status in patients with pulmonary embolism (PE) is poorly understood. A well-accepted nutritional status parameter, prognostic nutritional index (PNI), which was first demonstrated to be valuable in patients with cancer and gastrointestinal surgery, was introduced to patients with PE. Our aim was to evaluate the predictive value of PNI in outcomes of patients with PE. We evaluated the in-hospital and long-term (53.8 ± 5.4 months) prognostic impact of PNI on 251 patients with PE. During a median follow-up of 53.8 ± 5.4 months, 27 (11.6%) patients died in hospital course and 31 (13.4%) died in out-of-hospital course. The patients with lower PNI had significantly higher in-hospital and long-term mortality. The Cox proportional hazard analyses showed that PNI was associated with an increased risk of all-cause death for both unadjusted model and adjusted for all covariates. Our study demonstrated that PNI, calculated based on serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with PE.

show abstract

Section: Discussionmentioning

confidence: 99%

A Novel Independent Survival Predictor in Pulmonary Embolism: Prognostic Nutritional Index

Hayıroğlu

Keskin

et al. 2017

Clin Appl Thromb Hemost

Self Cite

View full text Add to dashboard Cite

show abstract

“…PNI has been used to predict and evaluate post-operative status in cancer patients for decades, ever since it was first published in 1983 (4). PNI has also been used to predict mortality in patients with ST-segment elevation myocardial infarction (STEMI) (5). PNI is currently determined by albumin (ALB) and total lymphocyte count (TLC), while its original formula used triceps skinfold thickness (TSF), serum transferrin concentration (TFN), and delayed hypersensitivity reaction (DHC, no reaction = 0, < 5mm induration =1, and > 5mm induration = 2) instead of the current TLC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

Tai

Guo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet. Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients. Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7% and 70.4%. Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.

show abstract

“…The nutritional status of the patients has been recently studied as having significant impact on prognosis, in a sense that malnutrition can negatively impact patient outcomes in various chronic disorders, from oncological to cardiovascular disease, and from chronic heart failure to stable coronary artery disease, myocardial infarction, or lower limb ischemia. [16][17][18][19][20][21][22][23][24] Evaluation of the nutritional status could become a new prognostic marker for such patients, while dietary supplements and malnutrition corrective therapies may beneficially influence the prognosis of patients with chronic heart failure. 25,26 The CONUT score (Controlling Nutri- impact mortality in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…The score reflects the immune and nutritional status and can indicate systemic inflammation, and is associated with higher mortality in surgical, medical, cardiovascular, and oncological patients. [19][20][21][22] Although the negative influence of a poor nutritional status has been evaluated in previous studies on the prognosis and outcome of stable and decompensated chronic heart failure patients, 16,21,23 as well as in patients with stable coronary artery disease or hypertension, 18,24 the usefulness of the CONUT and PNI scores as markers for blood vulnerability on the early outcome of subjects with ST and non-ST elevation AMI is still not completely elucidated.…”

Section: Introductionmentioning

confidence: 99%

Inter-relation between Altered Nutritional Status and Clinical Outcomes in Patients with Acute Myocardial Infarction Admitted in a Tertiary Intensive Cardiac Care Unit

Rus

Opincariu

Hodaş

et al. 2018

Journal of Cardiovascular Emergencies

View full text Add to dashboard Cite

Background: The impact of nutritional status on the early outcome of subjects with acute myocardial infarction (AMI) is still not completely elucidated. This study aimed to assess the correlation between nutritional status, as expressed by the CONUT and PIN scores, and (1) clinical and laboratory characteristics, (2) complication rates, and (3) length of hospitalization, in patients with AMI. Materials and methods: We included 56 consecutive patients with AMI who underwent primary percutaneous intervention and stenting. Evaluation of the nutritional status was comprised in the calculation of the CONUT and PNI scores. The study population was divided into 2 groups according to the calculated CONUT score, as follows: group 1 – CONUT score <3 points (normal to mildly impaired nutritional status) and group 2 – CONUT score ≥3 points (moderate to severe malnutrition). The primary end-point of the study was the rate of in-hospital complications (left ventricular free wall rupture, hemodynamic instability requiring inotropic medication, high-degree atrioventricular block, the need for temporary cardiostimulation, supraventricular and ventricular arrhythmias and in-hospital cardiac arrest). The secondary end-points included the duration of hospitalization and the length of stay in the intensive cardiac care unit. Results: In total, 56 patients (44.64% with STEMI, 55.35% with NSTEMI) with a mean age of 61.96 ± 13.42 years, 58.92% males were included in the study. Group distribution was: group 1 – 76.78% (n = 43), group 2 – 23.21% (n = 23). There were no differences between the two groups regarding age, gender, cardiovascular risk factors, or comorbidities. PNI index in group 1 was 54.4 ± 10.4 and in group 2 41.1 ± 2.8, p <0.0001. Serum albumin was significantly lower in group 1 – 4.1 ± 0.3 vs. group 2 – 3.6 ± 0.3 (p <0.0001), similarly to total cholesterol levels (group 1 – 194.9 ± 41.5 vs. group 2 – 161.2 ± 58.2, p = 0.02). The complete blood cell count showed that group 2 presented lower levels of hematocrit (p = 0.003), hemoglobin (p = 0.002), and lymphocytes (p <0.0001) compared to group 1, but a significantly higher platelet count (p = 0.001), mean platelet volume (p = 0.03), neutrophil/lymphocyte (p <0.0001) and platelet/lymphocyte (p <0.0001) ratios, indicating enhanced blood thrombogenicity and inflammation. Regarding in-hospital complications, group 2 presented a higher rate of hemodynamic instability (group 1 – 11.6% vs. group 2 – 38.4%, p = 0.02). The overall hospitalization period was 7.7 ± 1.4 days in group 1 vs. 10.2 ± 4.8 days in group 2, p = 0.06; while the duration of stay in the intensive cardiac care unit was 2.6 ± 0.5 days in group 1 vs. 4.0 ± 2.5 days in group 2, p = 0.02. Conclusions: This study proved that nutritional deficit in acute myocardial patients who undergo revascularization is associated with an increased rate of in-hospital complications and with a longer observation time in a tertiary intensive cardiac care unit.

show abstract

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

Cited by 74 publications

References 22 publications

A Novel Independent Survival Predictor in Pulmonary Embolism: Prognostic Nutritional Index

A Novel Independent Survival Predictor in Pulmonary Embolism: Prognostic Nutritional Index

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

Inter-relation between Altered Nutritional Status and Clinical Outcomes in Patients with Acute Myocardial Infarction Admitted in a Tertiary Intensive Cardiac Care Unit

Contact Info

Product

Resources

About