The Combination Effect of the Red Blood Cell Distribution Width and Prognostic Nutrition Index on the Prognosis in Patients Undergoing PCI.

IF 4.8 2区 医学 Q1 NUTRITION & DIETETICS Nutrients Pub Date : 2024-09-19 DOI:10.3390/nu16183176
Likun Huo, Wenjuan Zhao, Xiang Ji, Kangyin Chen, Tong Liu
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Abstract

Background: Inflammation and malnutrition are related to adverse clinical outcomes in patients with coronary artery disease (CAD). However, it is unclear whether there is a relationship between the PNI (prognostic nutritional index) and RDW (red blood cell distribution width) regarding 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. The patients were stratified into four groups according to the PNI [high PNI (H-PNI) and low PNI (L-PNI)] and RDW [high RDW (H-RDW) and low RDW (L-RDW)]. The cutoff values of RDW and PNI were calculated using receiver-operating characteristic curve analysis. The primary endpoint was 1-year all-cause mortality (ACM). The secondary endpoint was major adverse cardiac cerebrovascular events (MACCEs), the composite of cardiac death (CD), the recurrence of MI, target lesion revascularization (TLR), and stroke. A Cox proportional hazards model was used to evaluate the association between the PNI, RDW, and clinical endpoints.

Results: During 1-year follow-up, 235 (4.19%) patients died. In multivariate regression analysis, the L-PNI/H-RDW group was found to have the highest risk of 1-year ACM [hazard ratio (HR) = 8.85, 95% confidence interval (CI): 5.96-13.15, p = 0.020] with the H-PNI/L-RDW group as a reference, followed by the L-PNI/L-RDW (HR = 3.96, 95% CI: 2.60-6.00, p < 0.001) and H-RDW/H-PNI groups (HR = 3.00, 95% CI: 1.99-4.50, p < 0.001). Nomograms were developed to predict the probability of 1-year ACM and MACCEs.

Conclusions: CAD patients with L-PNI and H-RDW experienced the worst prognosis. The combination of PNI and RDW was a strong predictor of 1-year ACM. The coexistence of PNI and RDW appears to have a synergistic effect, providing further information for the risk stratification of CAD patients.

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红细胞分布宽度和预后营养指数对PCI患者预后的联合影响
背景:炎症和营养不良与冠状动脉疾病(CAD)患者的不良临床预后有关。然而,PNI(预后营养指数)和 RDW(红细胞分布宽度)对接受经皮冠状动脉介入治疗(PCI)的 CAD 患者的预后是否有影响,目前尚不清楚:回顾性选取了5605名连续接受PCI治疗的CAD患者。根据 PNI(高 PNI(H-PNI)和低 PNI(L-PNI))和 RDW(高 RDW(H-RDW)和低 RDW(L-RDW))将患者分为四组。RDW和PNI的临界值是通过接收器运行特征曲线分析计算得出的。主要终点是 1 年全因死亡率(ACM)。次要终点是主要心脏脑血管不良事件(MACCEs),即心脏死亡(CD)、心肌梗死复发、靶病变血运重建(TLR)和中风的复合终点。采用 Cox 比例危险模型评估 PNI、RDW 和临床终点之间的关联:随访一年期间,235 名患者(4.19%)死亡。在多变量回归分析中发现,L-PNI/H-RDW 组 1 年 ACM 风险最高 [危险比 (HR) = 8.85,95% 置信区间 (CI):5.96-13.15,P = 0.020],其次是 L-PNI/L-RDW 组(HR = 3.96,95% CI:2.60-6.00,p < 0.001)和 H-RDW/H-PNI 组(HR = 3.00,95% CI:1.99-4.50,p < 0.001)。结论:结论:患有 L-PNI 和 H-RDW 的 CAD 患者预后最差。结论:L-PNI 和 H-RDW 的 CAD 患者预后最差,PNI 和 RDW 组合是 1 年 ACM 的有力预测因素。PNI 和 RDW 的共存似乎具有协同效应,为 CAD 患者的风险分层提供了更多信息。
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来源期刊
Nutrients
Nutrients NUTRITION & DIETETICS-
CiteScore
9.20
自引率
15.30%
发文量
4599
审稿时长
16.74 days
期刊介绍: Nutrients (ISSN 2072-6643) is an international, peer-reviewed open access advanced forum for studies related to Human Nutrition. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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