The Role of Prognostic Nutritional Index in Predicting Multivessel Disease in Patients with ST-Segment Elevation Myocardial Infarction

Year 2023, Volume: 4 Issue: Supplemental Issue, 181 - 186, 20.10.2023

Emrah Aksakal , Oğuzhan Birdal

https://doi.org/10.56766/ntms.1363559

Abstract

Acute coronary syndromes (ACS) are common diseases and one of the most common causes of death in the world. The most feared ACS is ST segment elevation myocardial infarction (STEMI). Approximately 50% of STEMI patients have lesions in multivessel disease (MVD), and this is associated with poor outcomes. In this study, we aimed to evaluate prognostic nutritional index (PNI) in patients with STEMI and MVD. 1708 patients diagnosed with STEMI were included in the study. The patients' blood parameters, electrocardiography and echocardiography findings, coronary angiography images were recorded and calculations were made. The mean follow-up period was 38.8±10.3 months. The mean age of 1708 patients was 56.7±12.3 years, and 1370 (80.2) of the patients were male. Lower PNI was associated with MVD (+). Mortality was observed more in the MVD (+) group (p<0.001). In addition, PNI was observed to be negatively correlated with the Syntax Score (SS), which indicates vascular severity (r=-0.347). In STEMI patients, PNI can predict high SS and be used as an indicator of MVD.

Keywords

ST elevation myocardial infarction, multivessel disease, prognostic nutritional index, mortality

References

• 1. Lindstrom M, DeCleene N, Dorsey H, et al. Global Burden of Cardiovascular Diseases and Risks Collaboration, 1990-2021. J Am Coll Cardiol. 2022; 80(25):2372-25.
• 2. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38):3720-26.
• 3. Cui K, Lyu S, Song X, et al. Long-Term Safety and Efficacy of Staged Percutaneous Coronary Intervention for Patients with ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Disease. The American journal of cardiology. 2019; 124(3):334-42.
• 4. Pimor A, Auffret V, Didier R, et al. Immediate complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease treated by primary percutaneous coronary intervention: Insights from the ORBI registry. Arch Cardiovasc Dis. 2018; 111(11):656-65.
• 5. Bainey KR, Engstrom T, Smits PC, et al. Complete vs Culprit-Lesion-Only Revascularization for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis. JAMA Cardiol. 2020; 5(8):881-88.
• 6. Safak O, Yildirim T, Emren V, et al. Prognostic Nutritional Index as a Predictor of No-Reflow Occurrence in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Angiology. 2023; 8:33197231193223.
• 7. Hua X, Long ZQ, Huang X, et al. The Value of Prognostic Nutritional Index (PNI) in Predicting Survival and Guiding Radiotherapy of Patients With T1-2N1 Breast Cancer. Front Oncol. 2019; 9:1562.
• 8. Kurmus O, Aslan T, Eren M, et al. Nutritional status and severity of coronary artery disease. Coron Artery Dis. 2021; 32(7):644-49.
• 9. Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduct Target Ther. 2022; 7(1):131.
• 10. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019; 40(3):237-69.
• 11. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39(2):119-77.
• 12. Marso SP. Revascularization Approaches. Chronic Coronary Artery Disease. 2018:337-54.
• 13. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019; 40(2):87-165.
• 14. Safarian H, Alidoosti M, Shafiee A, Salarifar M, Poorhosseini H, Nematipour E. The SYNTAX Score Can Predict Major Adverse Cardiac Events Following Percutaneous Coronary Intervention. Heart Views. 2014; 15(4):99-105
• 15. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016; 4(13): 256.
• 16. Madhavan MV, Gersh BJ, Alexander KP, Granger CB, Stone GW. Coronary Artery Disease in Patients >/=80 Years of Age. J Am Coll Cardiol. 2018; 71(18):2015-40.
• 17. Kannel WB. Coronary heart disease risk factors in the elderly. Am J Geriatr Cardiol. Mar-Apr 2002; 11(2):101-7.
• 18. Rymer JA, Rao SV. Anemia and coronary artery disease: pathophysiology, prognosis, and treatment. Coron Artery Dis. 2018; 29(2):161-67.
• 19. Cai Q, Mukku VK, Ahmad M. Coronary artery disease in patients with chronic kidney disease: a clinical update. Curr Cardiol Rev. 2013; 9(4):331-39.
• 20. Korkmaz S, Demirkan B, Altay H, et al. Serum creatinine is independently associated with angiographic extent of coronary artery disease in patients with stable angina pectoris. Anadolu Kardiyol Derg. 2011; 11(5):407-13.
• 21. Marx N, Federici M, Schutt K, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023; 44(39):4043-40.
• 22. Zhao T, Gong HP, Dong ZQ, Du YM, Lu QH, Chen HQ. Predictive value of fasting blood glucose for serious coronary atherosclerosis in non-diabetic patients. J Int Med Res. 2019; 47(1):152-58.
• 23. Libby P, Ridker PM, Hansson GK, Leducq Transatlantic Network on A. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009; 54(23):2129-38.
• 24. Nunez J, Minana G, Bodi V, et al. Low lymphocyte count and cardiovascular diseases. Curr Med Chem. 2011; 18(21):3226-33.
• 25. Kurtul A, Murat SN, Yarlioglues M, et al. Usefulness of Serum Albumin Concentration to Predict High Coronary SYNTAX Score and In-Hospital Mortality in Patients With Acute Coronary Syndrome. Angiology. 2016; 67(1):34-40.
• 26. Pan HC, Sheu WH, Lee WJ, et al. Coronary severity score and C-reactive protein predict major adverse cardiovascular events in patients with stable coronary artery disease (from the Taichung CAD study). Clin Chim Acta. 2015; 445:93-100.
• 27. Zhang S, Wang H, Chen S, et al. Prognostic nutritional index and prognosis of patients with coronary artery disease: A systematic review and meta-analysis. Front Nutr. 2023; 10:1114053.
• 28. Akbuga K, Ferik OK, Yayla KG, et al. Prognostic Nutritional Index as a New Prediction Tool for Coronary Collateral Development. Acta Cardiol Sin. 2022; 38(1):21-26.
• 29. Tolunay H, Görmel S, Asil S, et al. The role of nutritional indexes in predicting coronary artery disease severity in acute coronary syndrome. Gulhane Medical Journal. 2021; 63(2):147-52.