Long‐Term Prognostic Value of the Prognostic Nutritional Index in Patients Undergoing Coronary Artery Bypass Grafting

作者：Dong Hyun Gim, Seung Hun Lee, Ji Hyun Cha, Ki Hong Choi, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Joo‐Yong Hahn, Seung‐Hyuk Choi, Hyeon‐Cheol Gwon, Dong Seop Jeong, Su Ryeun Chung, Yang Hyun Cho, Kiick Sung, Wook Sung Kim, Jeong Hoon Yang · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.125.043597 · 被引用次数：3 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Inflammatory Biomarkers in Disease Prognosis、Hip and Femur Fractures

Background The Prognostic Nutritional Index (PNI) as an indicator of nutritional and immunological status has been widely applied in various medical conditions. However, its prognostic role in postoperative outcomes after coronary artery bypass grafting has not been fully elucidated. This study investigated the long‐term prognostic impact of PNI for patients undergoing coronary artery bypass grafting. Methods A total of 6626 patients who underwent coronary artery bypass grafting from 2001 to 2017 were analyzed. PNI was calculated as 10×serum albumin (g/ dL )+0.005×total lymphocyte count (per mm 3 ). Results PNI is negatively correlated with age ( r =−0.24, P <0.001) and positively correlated with body mass index ( r =0.13, P <0.001). PNI was significantly associated with all‐cause mortality during a median follow‐up of 10.0 years (hazard ratio [HR], 0.96 [per 1 increase] [95% CI, 0.96–0.97]; P <0.001). The low‐PNI group (≤47, n=3956) showed a higher incidence of all‐cause mortality than those with high PNI (>47, n=2670) (64.8% versus 45.5%; adjusted HR, 1.19 [95% CI, 1.09–1.30]; P <0.001). The model including PNI showed better prognostic discrimination for predicting all‐cause mortality during long‐term follow‐up compared with the model with only clinical variables (C index, 0.733 [95% CI, 0.721–0.745] versus 0.763 [95% CI, 0.751–0.774]; integrated discrimination improvement, 0.037 [95% CI, 0.032–0.042]; net reclassification index, 0.334 [95% CI, 0.286–0.383]; P <0.001 for ea...