{"title":"老年营养风险指数与 GRACE 评分相结合对预测 PCI 后非 ST 段抬高心肌梗死老年患者一年不良预后风险的预测价值","authors":"Hong-Li Wu, Bater Hurile, Zhi-Peng Li, Hong-Wei Zhao","doi":"10.2147/cia.s457971","DOIUrl":null,"url":null,"abstract":"<strong>Background:</strong> As a nutritional indicator, a lower level of geriatric nutritional risk index (GNRI) has been suggested as a predictor for poor prognosis in acute coronary syndrome (ACS). However, whether GNRI could improve the predictive value of the Global Registry of Acute Coronary Events (GRACE) score for the prognosis in elderly patients with non-ST segment elevation myocardial infarction (NSTEMI) after PCI remains unclear.<br/><strong>Methods:</strong> A total of 446 elderly patients with NSTEMI after percutaneous coronary intervention (PCI) were consecutively enrolled. Patients were divided into major adverse cardiovascular and cerebrovascular events (MACCE) group and control group according to the occurrence of MACCE during one year follow up. The clinical parameters including GNRI were compared to investigate the predictors for MACCE. The performance after the addition of GNRI to the GRACE score for predicting MACCE was determined.<br/><strong>Results:</strong> A total of 68 patients developed MACCE. In unadjusted analyses, the rate of MACCE was significantly higher in the 93.8<gnri (95%=\"\" (p=\"\" 0.000–=\"\" 0.001),=\"\" 0.001).<br=\"\" 0.001);=\"\" 0.004–=\"\" 0.011=\"\" 0.023,=\"\" 0.094=\"\" 0.177,=\"\" 0.792=\"\" 0.885=\"\" 102.7=\"\" 93.8=\"\" <=\"\" addition=\"\" after=\"\" age,=\"\" and=\"\" c-index=\"\" ci,=\"\" elderly=\"\" for=\"\" from=\"\" gnri=\"\" gnri,=\"\" grace=\"\" group=\"\" group.=\"\" idi=\"\" improved=\"\" in=\"\" increasing=\"\" independent=\"\" logistics=\"\" macce=\"\" model=\"\" nri=\"\" nstemi=\"\" of=\"\" p=\"\" patients=\"\" pci,=\"\" pci.=\"\" prediction=\"\" predictors=\"\" regression=\"\" score=\"\" showed=\"\" significantly=\"\" that=\"\" the=\"\" to=\"\" versus=\"\" was=\"\" were=\"\" with=\"\" ≤=\"\" ≥=\"\"></gnri><strong>Conclusion:</strong> Combining GNRI and GRACE score could significantly improve the predictive value of one year MACCE in elderly patients with NSTEMI after PCI. By using this combined new risk model, we could easily identify the high-risk populations in clinical practice, so as to better monitor and manage them.<br/><br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"8 1","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Predictive Value of Geriatric Nutritional Risk Index Combined with the GRACE Score in Predicting the Risk of One Year Poor Prognosis in Elderly Patients with Non-ST Segment Elevation Myocardial Infarction After PCI\",\"authors\":\"Hong-Li Wu, Bater Hurile, Zhi-Peng Li, Hong-Wei Zhao\",\"doi\":\"10.2147/cia.s457971\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<strong>Background:</strong> As a nutritional indicator, a lower level of geriatric nutritional risk index (GNRI) has been suggested as a predictor for poor prognosis in acute coronary syndrome (ACS). However, whether GNRI could improve the predictive value of the Global Registry of Acute Coronary Events (GRACE) score for the prognosis in elderly patients with non-ST segment elevation myocardial infarction (NSTEMI) after PCI remains unclear.<br/><strong>Methods:</strong> A total of 446 elderly patients with NSTEMI after percutaneous coronary intervention (PCI) were consecutively enrolled. Patients were divided into major adverse cardiovascular and cerebrovascular events (MACCE) group and control group according to the occurrence of MACCE during one year follow up. The clinical parameters including GNRI were compared to investigate the predictors for MACCE. The performance after the addition of GNRI to the GRACE score for predicting MACCE was determined.<br/><strong>Results:</strong> A total of 68 patients developed MACCE. In unadjusted analyses, the rate of MACCE was significantly higher in the 93.8<gnri (95%=\\\"\\\" (p=\\\"\\\" 0.000–=\\\"\\\" 0.001),=\\\"\\\" 0.001).<br=\\\"\\\" 0.001);=\\\"\\\" 0.004–=\\\"\\\" 0.011=\\\"\\\" 0.023,=\\\"\\\" 0.094=\\\"\\\" 0.177,=\\\"\\\" 0.792=\\\"\\\" 0.885=\\\"\\\" 102.7=\\\"\\\" 93.8=\\\"\\\" <=\\\"\\\" addition=\\\"\\\" after=\\\"\\\" age,=\\\"\\\" and=\\\"\\\" c-index=\\\"\\\" ci,=\\\"\\\" elderly=\\\"\\\" for=\\\"\\\" from=\\\"\\\" gnri=\\\"\\\" gnri,=\\\"\\\" grace=\\\"\\\" group=\\\"\\\" group.=\\\"\\\" idi=\\\"\\\" improved=\\\"\\\" in=\\\"\\\" increasing=\\\"\\\" independent=\\\"\\\" logistics=\\\"\\\" macce=\\\"\\\" model=\\\"\\\" nri=\\\"\\\" nstemi=\\\"\\\" of=\\\"\\\" p=\\\"\\\" patients=\\\"\\\" pci,=\\\"\\\" pci.=\\\"\\\" prediction=\\\"\\\" predictors=\\\"\\\" regression=\\\"\\\" score=\\\"\\\" showed=\\\"\\\" significantly=\\\"\\\" that=\\\"\\\" the=\\\"\\\" to=\\\"\\\" versus=\\\"\\\" was=\\\"\\\" were=\\\"\\\" with=\\\"\\\" ≤=\\\"\\\" ≥=\\\"\\\"></gnri><strong>Conclusion:</strong> Combining GNRI and GRACE score could significantly improve the predictive value of one year MACCE in elderly patients with NSTEMI after PCI. By using this combined new risk model, we could easily identify the high-risk populations in clinical practice, so as to better monitor and manage them.<br/><br/>\",\"PeriodicalId\":10417,\"journal\":{\"name\":\"Clinical Interventions in Aging\",\"volume\":\"8 1\",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-05-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Interventions in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/cia.s457971\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Interventions in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/cia.s457971","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The Predictive Value of Geriatric Nutritional Risk Index Combined with the GRACE Score in Predicting the Risk of One Year Poor Prognosis in Elderly Patients with Non-ST Segment Elevation Myocardial Infarction After PCI
Background: As a nutritional indicator, a lower level of geriatric nutritional risk index (GNRI) has been suggested as a predictor for poor prognosis in acute coronary syndrome (ACS). However, whether GNRI could improve the predictive value of the Global Registry of Acute Coronary Events (GRACE) score for the prognosis in elderly patients with non-ST segment elevation myocardial infarction (NSTEMI) after PCI remains unclear. Methods: A total of 446 elderly patients with NSTEMI after percutaneous coronary intervention (PCI) were consecutively enrolled. Patients were divided into major adverse cardiovascular and cerebrovascular events (MACCE) group and control group according to the occurrence of MACCE during one year follow up. The clinical parameters including GNRI were compared to investigate the predictors for MACCE. The performance after the addition of GNRI to the GRACE score for predicting MACCE was determined. Results: A total of 68 patients developed MACCE. In unadjusted analyses, the rate of MACCE was significantly higher in the 93.8Conclusion: Combining GNRI and GRACE score could significantly improve the predictive value of one year MACCE in elderly patients with NSTEMI after PCI. By using this combined new risk model, we could easily identify the high-risk populations in clinical practice, so as to better monitor and manage them.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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