Combined effect of inflammation and malnutrition for long-term prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a cohort study

BMC Cardiovascular Disorders, Journal Year: 2024, Volume and Issue: 24(1)

Published: June 17, 2024

Abstract Background Inflammation is a key driver of atherosclerotic diseases and often accompanied by disease-related malnutrition. However, the long-term burden dysregulated inflammation with superimposed undernutrition in patients acute coronary syndrome (ACS) remains unclear. This study sought to investigate double interplay malnutrition ACS undergoing percutaneous Coronary Intervention (PCI). Methods We retrospectively included 1,743 PCI from June 2016 through November 2017 grouped them according their baseline nutritional inflammatory status. Malnutrition was determined using risk index (NRI) score lower than 100 high-inflamed condition defined as hs-CRP over 2 mg/L. The primary outcome major adverse cardiovascular events (MACEs), compositing cardiac mortality, non-fatal myocardial infarction, stroke, unplanned revascularization. Long-term outcomes were examined Kaplan-Meier method compared log-rank test. Multivariable Cox proportional hazards regression analysis applied adjust for confounding. reclassification (NRI)/integrated discrimination (IDI) statistics estimated incremental prognostic impact NRI addition Global Registry Acute Events (GRACE) score. Results During median follow-up 30 months (ranges 30–36 months), 351 (20.1%) MACEs occurred. Compared nourished uninflamed group, malnourished group displayed significantly increased an adjusted hazard ratio 2.446 (95% CI: 1.464–4.089; P < 0.001). implications influenced patients’ status, it only associated among those ( interaction = 0.005). Incorporating into GRACE improved its predictive ability (NRI: 0.210, 0.001; integrated index; IDI: 0.010, 0.001) death 0.666, 0.023, 0.002). Conclusions Among PCI, signifies poorer outcomes. Their may be amplified each other jointly improve score’s prediction performance.

Language: Английский

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Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 11

Published: Jan. 7, 2025

Angiography-derived microcirculatory resistance (AMR) is proposed as a novel, pressure- temperature-wire-free and less-invasive method to evaluate coronary microvascular dysfunction (CMD). This study aims examine the prognostic role of CMD assessed by AMR in predicting adverse events acute syndrome (ACS) patients with chronic kidney disease (CKD). retrospective cohort included ACS CKD China-Japan Friendship Hospital from January 2016 November 2022. The were divided into non-CMD groups based on values less than or greater 250 mmHg*s/m. A total 345 eligible this study. During median follow-up 23.0 months, higher prevalence rate MACEs (28.3% vs. 15.1%, P = 0.003) death (20.2% 4.1%, 0.001) observed group. In multivariate Cox regression analysis, group had 1.843 times hazard ratio (HR) for developing (HR: 1.843, 95% CI: 1.071-3.174, 0.027) 5.325 HR 5.325, 1.979-14.327, < every 10 mmHg*s/m increment AMR. incorporation improved predictive accuracy GRACE score death. indicates that significantly related poor prognosis among CKD. Furthermore, could improve power risk score. These results indicated may serve valuable clinical tool classification, stratification therapy individualization these patients.

Language: Английский

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Association between controlling nutritional status score and the prognosis of patients with acute myocardial infarction: a systematic review and meta-analysis

Frontiers in Nutrition, Journal Year: 2025, Volume and Issue: 11

Published: Jan. 15, 2025

Recent studies have reported growing evidence supporting applying the controlling nutritional status (CONUT) score in acute myocardial infarction (AMI) patients. This investigation intended to ascertain link between CONUT scores and prognosis AMI population. Multiple electronic databases, encompassing PubMed, Web of Science, Embase, Cochrane Library, were retrieved from inception databases until July 20, 2024, explore adverse clinical outcomes individuals with AMI. Primary consisted major cardiovascular events (MACE) mortality, while secondary encompassed stroke, cardiac death, reinfarction, revascularization, ventricular arrhythmias, atrioventricular block. A random-effects meta-analysis was executed, treated as either categorical or continuous variables. Sensitivity analyses Egger's test conducted appraise robustness results publication bias, respectively. Subgroup executed account for various confounding factors. Moreover, GRADE system leveraged quality all outcomes. Fifteen included our analysis. The statistical on both variables unraveled that a high markedly linked an elevated risk MACE [categorical variable: odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.42-2.15; standardized mean difference (SMD) 1.02, CI 0.78-1.26], mortality (categorical OR 2.08, 1.70-2.55; SMD 1.16, 0.57-1.74), death 2.81, 1.67-4.73), reinfarction 2.21, 1.28-3.83), block 5.21, 1.83-14.89) However, no significant association found stroke 1.52, 0.98-2.35), revascularization 2.92, 0.58-14.79), arrhythmias 2.57, 0.06-107.21). may serve promising cost-effective prognostic biomarker PROSPERO: CRD42024574048.

Language: Английский

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Impact of geriatric nutritional risk index on clinical outcomes in acute coronary syndrome patients: a comprehensive meta-analysis

Coronary Artery Disease, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 17, 2025

Background The Geriatric Nutritional Risk Index (GNRI), derived from serum albumin levels and body weight relative to ideal weight, is a novel tool for assessing nutritional status. This meta-analysis explored the association between GNRI clinical outcomes in patients with acute coronary syndrome (ACS). Methods We systematically searched PubMed , Embase Web of Science studies evaluating ACS. Inclusion criteria were observational reporting all-cause mortality or major adverse cardiovascular events (MACEs) among ACS categorized by low versus normal GNRI. Data extraction quality assessment independently performed two authors, utilizing random-effects model account potential heterogeneity. Results Eleven cohort studies, encompassing 18 616 ACS, included. A was associated significantly increased risks (RR, 1.95; 95% CI, 1.63–2.34; P < 0.001; I ² = 32%) MACEs 1.93; 1.62–2.29; 25%). Subgroup analyses outcome showed consistent findings across varied study designs, patient demographics, follow-up periods ( subgroup differences all >0.05). Sensitivity conducted sequentially excluding individual confirmed stability these results. Conclusion at time admission significant predictor

Language: Английский

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The Effect of PNI Score on Renal Prognosis and Graft Rejection After Kidney Transplantation

Transplantation Proceedings, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

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Role of composite objective nutritional indexes in patients with chronic kidney disease

Frontiers in Nutrition, Journal Year: 2024, Volume and Issue: 11

Published: April 18, 2024

Malnutrition persists as one of the most severe symptoms in patients with chronic kidney disease (CKD) globally. It is a critical risk factor for cardiovascular and all-cause mortality CKD. Readily available objective indicators are used to calculate composite nutritional assessment indexes, including geriatric index, prognostic controlling status score. These indexes offer straightforward effective method evaluating predicting clinical outcomes This review presents supporting evidence on significance indexes.

Language: Английский

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Association between nutritional status, injury severity, and physiological responses in trauma patients

Frontiers in Physiology, Journal Year: 2024, Volume and Issue: 15

Published: Nov. 13, 2024

To evaluate the predictive value of Controlling Nutritional Status (CONUT) score and Injury Severity Score (ISS) in assessing physiological abnormalities outcomes trauma patients.

Language: Английский

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Predictive value of three nutritional indexes for disease activity in patients with inflammatory bowel disease

Annals of Medicine, Journal Year: 2024, Volume and Issue: 57(1)

Published: Dec. 20, 2024

Background Malnutrition is prevalent in patients with inflammatory bowel disease (IBD); however, its ability to predict the activity IBD remains unexplored. Therefore, this study aimed explore association between malnutrition and IBD.

Language: Английский

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Combined Effect of Inflammation and Malnutrition for Long-term Prognosis in Patients with Acute Coronary Syndrome: A Cohort Study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Dec. 13, 2023

Abstract Background Dysregulated inflammation with superimposed malnutrition may constitute a significant threat in acute coronary syndrome (ACS), which needs to be elucidated. We aimed explore the prevalence and combined predictive value of ACS patients. Methods Patients presenting undergoing percutaneous intervention (PCI) were retrospectively included stratified into four groups: nourished without elevated high-sensitivity C-reactive protein (hs-CRP), hs-CRP, malnourished hs-CRP. Elevated hs-CRP was determined as over 2.2mg/L, defined according nutritional risk index (NRI). The primary outcome major adverse cardiovascular events (MACEs), composite cardiac mortality, non-fatal myocardial infarction, stroke, unplanned revascularization. Results A total 1,743 patients ultimately included; 646 (37%) presented 119 (7%) considered malnourished. During median follow-up 30 months, 351 (20.1%) MACEs occurred. coexistence correlated worst outcomes among phenotypes, significantly increased (adjusted hazard ratio: 2.446; 95% confidence interval: 1.464 - 4.089; p <0.001). In subgroup analysis, NRI displayed MACEs-predicting merely rather than those (p for interaction = 0.005), suggesting modifying effect inflammation; simultaneously, prognostic implications influenced by patients’ baseline status, it only existed < 0.001). Conclusions Among PCI, double burden signifies poorer outcomes, their amplified each other, would provide facilitate more individualized care.

Language: Английский

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