Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention
Abstract Background Malnutrition affects the prognosis of cardiovascular disease. Acute myocardial infarction (AMI) has been a major cause of death around the world. Thus, we investigated the impact of malnutrition as defined by Geriatric Nutritional Risk Index (GNRI) on mortality in AMI patients. M...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-021-02448-x |
| _version_ | 1818979412811448320 |
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| author | Daisuke Kanda Yoshiyuki Ikeda Takuro Takumi Akihiro Tokushige Takeshi Sonoda Ryo Arikawa Kazuhiro Anzaki Ippei Kosedo Mitsuru Ohishi |
| author_facet | Daisuke Kanda Yoshiyuki Ikeda Takuro Takumi Akihiro Tokushige Takeshi Sonoda Ryo Arikawa Kazuhiro Anzaki Ippei Kosedo Mitsuru Ohishi |
| author_sort | Daisuke Kanda |
| collection | DOAJ |
| description | Abstract Background Malnutrition affects the prognosis of cardiovascular disease. Acute myocardial infarction (AMI) has been a major cause of death around the world. Thus, we investigated the impact of malnutrition as defined by Geriatric Nutritional Risk Index (GNRI) on mortality in AMI patients. Methods In 268 consecutive AMI patients who underwent percutaneous coronary intervention (PCI), associations between all-cause death and baseline characteristics including malnutrition (GNRI < 92.0) and Global Registry of Acute Coronary Events (GRACE) risk score were assessed. Results Thirty-three patients died after PCI. Mortality was higher in the 51 malnourished patients than in the 217 non-malnourished patients, both within 1 month after PCI (p < 0.001) and beyond 1 month after PCI (p = 0.017). Multivariate Cox proportional hazards regression modelling using age, left ventricular ejection fraction and GRACE risk score showed malnutrition correlated significantly with all-cause death within 1 month after PCI (hazard ratio [HR] 7.04; 95% confidence interval [CI] 2.30–21.51; p < 0.001) and beyond 1 month after PCI (HR 3.10; 95% CI 1.70–8.96; p = 0.037). There were no significant differences in area under the receiver-operating characteristic (ROC) curve between GRACE risk score and GNRI for predicting all-cause death within 1 month after PCI (0.90 vs. 0.81; p = 0.074) or beyond 1 month after PCI (0.69 vs. 0.71; p = 0.87). Calibration plots comparing actual and predicted mortality confirmed that GNRI (p = 0.006) was more predictive of outcome than GRACE risk score (p = 0.85) beyond 1 month after PCI. Furthermore, comparison of p-value for interaction of malnutrition and GRACE risk score for all-cause death within 1 month after PCI, beyond 1 month after PCI, and the full follow-up period after PCI were p = 0.62, p = 0.64 and p = 0.38, respectively. Conclusions GNRI may have a potential for predicting the mortality in AMI patients especially in beyond 1 month after PCI, separate from GRACE risk score. Assessment of nutritional status may help stratify the risk of AMI mortality. |
| first_indexed | 2024-12-20T16:59:08Z |
| format | Article |
| id | doaj.art-bb1af94d4b4e4470970158950247f772 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-20T16:59:08Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-bb1af94d4b4e4470970158950247f7722022-12-21T19:32:37ZengBMCBMC Cardiovascular Disorders1471-22612022-01-0122111010.1186/s12872-021-02448-xImpact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary interventionDaisuke Kanda0Yoshiyuki Ikeda1Takuro Takumi2Akihiro Tokushige3Takeshi Sonoda4Ryo Arikawa5Kazuhiro Anzaki6Ippei Kosedo7Mitsuru Ohishi8Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima UniversityAbstract Background Malnutrition affects the prognosis of cardiovascular disease. Acute myocardial infarction (AMI) has been a major cause of death around the world. Thus, we investigated the impact of malnutrition as defined by Geriatric Nutritional Risk Index (GNRI) on mortality in AMI patients. Methods In 268 consecutive AMI patients who underwent percutaneous coronary intervention (PCI), associations between all-cause death and baseline characteristics including malnutrition (GNRI < 92.0) and Global Registry of Acute Coronary Events (GRACE) risk score were assessed. Results Thirty-three patients died after PCI. Mortality was higher in the 51 malnourished patients than in the 217 non-malnourished patients, both within 1 month after PCI (p < 0.001) and beyond 1 month after PCI (p = 0.017). Multivariate Cox proportional hazards regression modelling using age, left ventricular ejection fraction and GRACE risk score showed malnutrition correlated significantly with all-cause death within 1 month after PCI (hazard ratio [HR] 7.04; 95% confidence interval [CI] 2.30–21.51; p < 0.001) and beyond 1 month after PCI (HR 3.10; 95% CI 1.70–8.96; p = 0.037). There were no significant differences in area under the receiver-operating characteristic (ROC) curve between GRACE risk score and GNRI for predicting all-cause death within 1 month after PCI (0.90 vs. 0.81; p = 0.074) or beyond 1 month after PCI (0.69 vs. 0.71; p = 0.87). Calibration plots comparing actual and predicted mortality confirmed that GNRI (p = 0.006) was more predictive of outcome than GRACE risk score (p = 0.85) beyond 1 month after PCI. Furthermore, comparison of p-value for interaction of malnutrition and GRACE risk score for all-cause death within 1 month after PCI, beyond 1 month after PCI, and the full follow-up period after PCI were p = 0.62, p = 0.64 and p = 0.38, respectively. Conclusions GNRI may have a potential for predicting the mortality in AMI patients especially in beyond 1 month after PCI, separate from GRACE risk score. Assessment of nutritional status may help stratify the risk of AMI mortality.https://doi.org/10.1186/s12872-021-02448-xAcute myocardial infarctionMalnutritionGNRIGRACE risk score |
| spellingShingle | Daisuke Kanda Yoshiyuki Ikeda Takuro Takumi Akihiro Tokushige Takeshi Sonoda Ryo Arikawa Kazuhiro Anzaki Ippei Kosedo Mitsuru Ohishi Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention BMC Cardiovascular Disorders Acute myocardial infarction Malnutrition GNRI GRACE risk score |
| title | Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| title_full | Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| title_fullStr | Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| title_full_unstemmed | Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| title_short | Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| title_sort | impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention |
| topic | Acute myocardial infarction Malnutrition GNRI GRACE risk score |
| url | https://doi.org/10.1186/s12872-021-02448-x |
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