Impact of Geriatric Nutritional Risk Index on cardiovascular outcomes in patients with stable coronary artery disease

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• 作者：Ayako Kunimura ; MD^a ; ^b ; ^{akuni1127@med.nagoya-u.ac.jp} ; Hideki Ishii ; MD ; PhD^a ; Tadayuki Uetani ; MD ; PhD^b ; Toshijirou Aoki ; MD^a ; Kazuhiro Harada ; MD^a ; Kenshi Hirayama ; MD^a ; Yosuke Negishi ; MD^a ; Yohei Shibata ; MD^a ; Takuya Sumi ; MD^a ; Kazuhiro Kawashima ; MD^a ; Yosuke Tatami ; MD^a ; Toshiki Kawamiya ; MD^a ; Dai Yamamoto ; MD^a ; Susumu Suzuki ; MD^a ; Tetsuya Amano ; MD ; PhD ; FJCC^c ; Toyoaki Murohara ; MD ; PhD ; FJCC^a
• 关键词：Malnutrition ; Stable coronary artery disease ; Geriatric Nutritional Risk Index ; Risk factors ; Cardiovascular outcomes
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：383-388
• 全文大小：498 K
• 卷排序：69

文摘

The association between malnutrition and cardiovascular prognosis in patients with stable coronary artery disease remains unclear. The aim of this study was to evaluate the association between Geriatric Nutritional Risk Index (GNRI), a simple tool to assess nutritional risk, and long-term outcomes after elective percutaneous coronary intervention (PCI).MethodsThis study consisted of 802 patients (age, 70 ± 10 years, male, 69%) who underwent elective PCI. GNRI was calculated at baseline as follows: GNRI = [14.89 × serum albumin (g/dl) + [41.7 × (body weight/body weight at body mass index of 22)]]. Patients were then divided into three groups as previously reported: GNRI <92, 92 to ≤98, and >98. The endpoint of this study was the composite of cardiac death or non-fatal myocardial infarction.ResultsDuring a median follow-up period of 1568 days, 56 cardiac events occurred. Using Kaplan–Meier analysis, the 4-year event-free rates were found to be 79% for GNRI <92, 90% for GNRI 92 to ≤98, and 97% for GNRI >98 (log-rank test p < 0.001). GNRI <92 and GNRI 92 to ≤98 showed 6.76-fold [95% confidence interval (CI) 3.13–14.56, p < 0.001] and 3.03-fold (HR 3.03, 95%CI 1.36–6.78, p = 0.007) increase in the incidences of cardiac death or non-fatal myocardial infarction compared with GNRI >98 after adjusting for confounding factors.ConclusionGNRI significantly associated with cardiac events after elective PCI. Further studies should be performed to establish appropriate therapeutic strategies for this vulnerable patient group.