Relationship between the prognostic nutritional index and long-term clinical outcomes in patients with stable coronary artery disease

Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Shitara, Jun; Endo, Hirohisa; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

doi:10.1016/j.jjcc.2018.01.012

Cited by 75 publications

(88 citation statements)

References 32 publications

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“…Various tools have been developed to evaluate nutritional status including the Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score and Mini Nutritional Assessment (MNA). These nutritional assessment tools showed prognostic value in patients with malignancy, heart failure, peripheral arterial disease and coronary artery disease [8][9][10][11]. Various studies have shown PNI to be a promising means of risk stratification for stable coronary artery disease (CAD) and acute ST-elevation myocardial infarction (STEMI) patients [11,12].…”

Section: Introductionmentioning

confidence: 99%

Association between Preoperative Nutritional Status and Clinical Outcomes of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Chen

Yang

et al. 2020

Nutrients

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Background: Malnutrition is associated with poor outcomes in patients with cancer, heart failure and chronic kidney disease. This study aimed to investigate the predictive value of the Controlling Nutritional Status (CONUT) score in coronary artery disease (CAD) patients. Methods: We recruited a cohort of 3118 patients with CAD undergoing percutaneous coronary intervention (PCI) from 2005 to 2015. Nutritional status was evaluated using the CONUT score, with higher scores reflecting worse nutritional status. Results: After adjustment for comorbidities and medication, an increased CONUT score was independently associated with a higher risk of acute myocardial infarction (AMI) (HR: 1.13; 95% CI: 1.03–1.24), cardiovascular (CV) death (HR: 1.18; 95% CI: 1.07–1.30), congestive heart failure (CHF) (HR: 1.11; 95% CI: 1.04–1.18), a major adverse cardiovascular event (MACE) (HR: 1.14; 95% CI: 1.07–1.22), and total CV events (HR: 1.11; 95% CI: 1.07–1.15). The subgroup analyses demonstrated that the association of the CONUT score existed independently of other established cardiovascular risk factors. In addition, CONUT significantly improved risk stratification for myocardial infarction (MI), cardiac death, CHF, MACEs and total CV events compared to conventional risk factors in CAD patients by the significant increase in the C-index (p < 0.05) and reclassification risk categories in cardiac death and MACEs. Conclusions: The CONUT score improved the risk prediction of adverse events compared to traditional risk factors in CAD patients after percutaneous coronary intervention (PCI).

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Section: Introductionmentioning

confidence: 99%

Association between Preoperative Nutritional Status and Clinical Outcomes of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Chen

Yang

et al. 2020

Nutrients

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“…[20,21]. PNI has been used as a predictive nutritional marker in patients with various diseases, such as malignancy [22], acute or chronic HF [23,24], heart failure with preserved ejection fraction (HFpEF) [25], pulmonary embolism (PE) [26], stable coronary artery disease (CAD) [27] and ST segment elevation myocardial infarction (STEMI) [28].…”

Section: Resultsmentioning

confidence: 99%

Düşük prognostik nütrisyonel indeks hipertrofik kardiyomiyopatili hastalarda kötü sonuçlar ile ilişkilidir

Tak¹,

Ekizler²,

Kafes³

et al. 2020

Turkish Journal of Clinics and Laboratory

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The aim of the study was to investigate poor nutritional status assessed by prognostic nutritional index (PNI) on the prognosis of patients with hypertrophic cardiomyopathy(HCM). Material and Methods: A total of 420 patients with HCM were assessed. The primary end point was defined as the occurrence of CV death that included sudden cardiac death (SCD), death due to HF and cardioembolic stroke-related death. Results: During the follow-up, primary end point was developed in 25 (6.0%) patients. Receiver operating characteristic (ROC) analysis showed that using a cutoff level of 40, PNI predicted the occurrence of primary end point with a sensitivity of 76% and specificity of 76.7%. In the multivariate model, low PNI was significant predictor of the primary end point. Conclusion: This study showed that lowerPNI level is an independent predictor of CV death in patients with HCM.

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“…All of these studies have found that the patients with lower PNI tended to have more than one comorbidity; and after multivariate analysis, the lower PNI remained a significant risk factor of adverse clinical outcomes. Wada H. et al 3 found the lower PNI as a predictor for adverse outcomes in stable angina pectoris. Some complex mechanisms contribute to the worse outcomes of malnutrition such as protein deficit, and immune system deficiency.…”

Section: Discussionmentioning

confidence: 97%

The impact of prognostic nutritional index on coronary flow reserve in patients with inflammatory bowel disease

Çalışkan¹,

Tatlısu²,

Kahraman³

et al. 2019

MMJ

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Objective:The recurring inflammation of mucosal layer of intestines is known as inflammatory bowel disease (IBD), which can be accompanied by nutritional deficiencies. The association between inflammation and coronary artery disease has been established. Coronary flow reserve (CFR), which is an established method to evaluate combined microvascular and epicardial flow of coronary arteries, can be assessed by using transthoracic echocardiography. The aim of this study was to evaluate the association of Prognostic Nutritional Index (PNI) with CFR in IBD patients. Method: This prospective study included 101 patients with IBD. These patients were compared to control group (n=32). PNI was calculated by using serum albumin level and lymphocyte count. CFR was assessed by using Doppler echocardiography. Results: Multivariate regression analysis indicated that the presence of IBD, age (>40 years) and decreased PNI (<53.8) independently predict impairment of CFR. The area under the curve (AUC) was 75.1% (95% CI:0.664-0.838), and PNI levels were significant predictor of low CFR (p<0.001). Conclusion: This study showed that PNI, which is calculated using the serum level of albumin and lymphocyte count, is a strong predictor of decreased CFR in IBD patients in remission. Our findings support previous studies showing the relationship between PNI and coronary artery disease. This immunonutritional index has only two components and is easy to calculate, and inexpensive.Keywords: Coronary flow reserve, inflammatory bowel disease, prognostic nutritional index ÖZ Amaç: Nutrisyonel yetersizliklerin eşlik edebildiği bağırsak mukoza katmanının tekrarlayıcı inflamasyonu, inflamatuvar bağırsak hastalığı (İBH) olarak bilinmektedir. İnflamasyon ve koroner arter hastalığının ilişkisi ortaya konulmuştur. Mikrovasküler ve epikardiyal akımı kombine bir şekilde değerlendirebilen koroner akım rezervi (KAR), transtorasik ekokardiyografi ile değerlendirilebilir. Bu çalışmanın amacı, İBH hastalarında prognostik nutrisyonel indeks (PNI) ile KAR arasındaki ilişkiyi değerlendirmekti. Yöntem: Bu çalışma, prospektif olarak dahil edilen 101 İBH hastasını içermektedir. Bu hastalar kontrol grubu (n=32) ile karşılaştırılmıştır. PNI, serum albümin düzeyi, lenfosit sayısı kullanılarak hesaplanmıştır. KAR, doppler ekokardiyografi ile değerlendirilmiştir. Bulgular: Çok değişkenli regresyon analizi İBH varlığı, yaş (>40) ve azalmış PNI'nın (<53,8) KAR'daki bozulmayı bağımsız bir şekilde predikte ettiğini ortaya çıkarmıştır. Eğri altında kalan alan (AUC) %75'di (95% CI: 0,664-0,838) ve PNI seviyesi düşük KAR için anlamlı bir prediktördü (p<0,001). Sonuç: Bu çalışma göstermiştir ki serum albümin seviyesi, lenfosit sayısı ile hesaplanan PNI, remisyondaki İBH hastalarında azalmış KAR için güçlü bir prediktördür. Çalışmamız PNI ile koroner arter hastalığı ilişkisini gösteren önceki çalışmaları desteklemektedir. Bu immunonutrisyonel indeks sadece iki komponente sahiptir, kolayca hesaplanabilir ve ucuzdur.Anahtar kelimeler: Koroner akım rezervi, inflamatuvar bağırsak h...

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Relationship between the prognostic nutritional index and long-term clinical outcomes in patients with stable coronary artery disease

Abstract: The PNI was significantly associated with long-term cardiovascular outcomes in patients with stable CAD. Assessing PNI may be useful for risk stratification of CAD patients undergoing elective PCI.

Cited by 75 publications

References 32 publications

Association between Preoperative Nutritional Status and Clinical Outcomes of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Association between Preoperative Nutritional Status and Clinical Outcomes of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Düşük prognostik nütrisyonel indeks hipertrofik kardiyomiyopatili hastalarda kötü sonuçlar ile ilişkilidir

The impact of prognostic nutritional index on coronary flow reserve in patients with inflammatory bowel disease

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