Association of prognostic nutritional index level and diabetes status with the prognosis of coronary artery disease: a cohort study

作者：Tianyu Li, Deshan Yuan, Peizhi Wang, Guyu Zeng, Sida Jia, Ce Zhang, Pei Zhu, Ying Song, Xiaofang Tang, Runlin Gao, Bo Xu, Jinqing Yuan · 发表于：Diabetology & Metabolic Syndrome · 年份：2023 · DOI：10.1186/s13098-023-01019-8 · 被引用次数：17 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Nutrition and Health in Aging、Cardiovascular Disease and Adiposity

BACKGROUND: Malnutrition and inflammation are associated with adverse clinical outcomes in patients with diabetes or coronary artery disease (CAD). Prognostic nutritional index (PNI) is a comprehensive and simple indicator reflecting nutritional condition and immunological status. Whether there is a crosstalk between nutritional-immunological status and diabetes status for the impact on the prognosis of coronary artery disease (CAD) is unclear. METHODS: A total of 9429 consecutive CAD patients undergoing percutaneous coronary intervention were grouped by diabetes status [diabetes (DM) and non-diabetes (non-DM)] and preprocedural PNI level [high PNI (H-PNI) and low PNI (L-PNI)] categorized by the statistically optimal cut-off value of 48.49. The primary endpoint was all-cause death. RESULTS: During a median follow-up of 5.1 years (interquartile range: 5.0-5.1 years), 366 patients died. Compared with the non-DM/H-PNI group, the DM/L-PNI group yielded the highest risk of all-cause death (adjusted hazard ratio: 2.65, 95% confidence interval: 1.97-3.56, p < 0.001), followed by the non-DM/L-PNI group (adjusted hazard ratio: 1.44, 95% confidence interval: 1.05-1.98, p = 0.026), while DM/H-PNI was not associated with the risk of all-cause death. The negative effect of L-PNI on all-cause death was significantly stronger in diabetic patients than in nondiabetic patients (p for interaction = 0.037). Preprocedural PNI category significantly improved the Global Registry of Acute Coronary ...