老年营养风险指数对冠状动脉慢性完全闭塞病变患者经皮冠状动脉介入治疗术后远期预后的预测价值

Objective To investigate the relationship between nutritional status and the long-term prognosis after percutaneous coronary intervention （PCI） in elderly patients with chronic total occlusion （CTO）. Methods This study included 346 elderly patients with CTO treated with PCI in ou hospital between June 2013 and October 2017. Based on the geriatric nutritional risk index （GNRI），all patients were divided into 3 groups： no malnutrition group （GNRI≥98，n=186），low risk of malnutrition group（92≤GNRI＜98，n=114），and the moderate/high risk of malnutrition group（GNRI＜92，n=46）. The primary endpoint event was all-cause mortality and the secondary endpoint event was cardiovascular death. Results The mean age of the 346 patients was 72 years. At a median followup of 33 months， Kaplan-Meier curves showed that the moderate/high malnutrition risk group had a worse long-term prognosis for both all-cause and cardiovascular mortality than the other two groups （Log-rank analysis， all-cause mortality P=0.004， cardiac mortality P=0.003）. Multivariate COX regression analysis suggested that all-cause mortality outcomes were associated with moderate/severe malnutrition， lymphocyte count and left ventricular ejection fraction； while the cardiovascular mortality outcome was associated with moderate/ severe malnutrition only. The risk of all-cause mortality and cardiovascular mortality was significantly increased in the moderate/high risk group of malnutrition compared with patients without malnutrition（HR 2.580，95%CI 1.139–5.842，P=0.023； HR 4.709，95%CI 1.321–16.787，P=0.017）. Conclusions GNRI nutritional index is an independent predictor of all-cause mortality and cardiovascular mortality after PCI in elderly CTO patients.