The combination effect of RDW and PNI on the prognosis for CAD patients undergoing PCI

Abstract

Background：Inflammation and malnutrition are related to adverse clinical outcomes in patients with coronary artery disease (CAD). Nutritional status is an important condition that affects inflammation. However, it is yet unclear whether there is a joint between PNI(prognostic nutritional index) and RDW(red blood cell distribution width) for the impact on the prognosis in patients with CAD undergoing percutaneous coronary intervention（PCI）. Methods ：A total of 5605 consecutive CAD patients undergoing PCI were selected retrospectively, and stratified by combination of PNI and RDW level. The cutoff values of RDW and PNI for predicting 1-year all-cause mortality (ACM) were calculated using receiver operating characteristic curves analysis. The primary endpoint was 1-year ACM. Results ：During 1-year follow-up, 235 (4.19%) patients died. In multivariate regression analysis, the L-PNI/H-RDW group [hazard ratio (HR): 8.85, 95% confidence interval (CI) : 5.96,13.15, p＜0.001] was found to be the highest risk of ACM with H-PNI/L-RDW group as the reference, followed by the L-PNI/L-RDW group (HR:3.96, 95%CI: 2.60,6.00) and H-RDW/H-PNI group(HR:3.00,95%CI:1.99–4.50).The combination of PNI and RDW was a strong predictor of 1- year ACM. Conclusions CAD patients with L-PNI and H-RDW experienced the worst prognosis. The coexistence of PNI and RDW appears to have a synergistic effect, providing further information for the risk stratification of CAD patients.