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Purpose <p>Acute coronary syndrome (ACS) remains a leading cause of global mortality, with ischemic heart disease accounting for nearly half of all cardiovascular deaths. Emerging evidence highlights the connections between malnutrition, systemic inflammation, and cardiovascular outcomes, fueling interest in potential biomarkers. The Prognostic Nutritional Index (PNI), derived from serum albumin and lymphocyte counts, has garnered significant attention. However, its specific impact on cardiovascular prognosis remains uncertain.</p> Patients and methods <p>From January 2016 to December 2018, 1,408 ACS patients undergoing percutaneous coronary intervention (PCI) were recruited at the Affiliated Hospital of Chengde Medical University. The primary endpoint was major adverse cardiac events (MACEs), defined as cardiac death or recurrent acute myocardial infarction (AMI).</p> Results <p>Among the 1369 patients followed, 52 experienced MACEs. PNI significantly differed between the MACE and non-MACE groups. The area under the curve (AUC) for PNI was 0.714 (<i>P</i> &lt; 0.001, 95% CI 0.642–0.785). Based on Youden’s index, the optimal PNI cut-off was 46.905. Kaplan-Meier analysis revealed lower cumulative survival in the low PNI group (log-rank <i>P</i> &lt; 0.001). Multivariate Cox regression identified Cr ≥110 µmol/L (HR: 4.353, 95% CI 1.632–11.611, <i>P</i> = 0.003), LVEF ≤40% (HR: 5.646, 95% CI 2.126–14.992, <i>P</i> = 0.001), and PNI &lt;46.905 (HR: 2.822, 95% CI 1.429–5.575, <i>P</i> = 0.003) as independent risk factors. A restricted cubic spline demonstrated that lower PNI is associated with a higher MACE risk.</p> Conclusion <p>A PNI of less than 46.905 may serves as an independent prognostic factor for ACS patients post-PCI in our cohort, potentially aiding in identifying high-risk individuals; however, this cutoff requires external validation in broader populations.</p>

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Prognostic Nutritional Index as an independent risk factor for predicting outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月5日

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  • Haoran Zhang,
  • Linlin Wang,
  • Aoxue Mei,
  • Shuang Xie,
  • Ge Song,
  • Lixian Sun,
  • Ying Zhang

摘要

Purpose

Acute coronary syndrome (ACS) remains a leading cause of global mortality, with ischemic heart disease accounting for nearly half of all cardiovascular deaths. Emerging evidence highlights the connections between malnutrition, systemic inflammation, and cardiovascular outcomes, fueling interest in potential biomarkers. The Prognostic Nutritional Index (PNI), derived from serum albumin and lymphocyte counts, has garnered significant attention. However, its specific impact on cardiovascular prognosis remains uncertain.

Patients and methods

From January 2016 to December 2018, 1,408 ACS patients undergoing percutaneous coronary intervention (PCI) were recruited at the Affiliated Hospital of Chengde Medical University. The primary endpoint was major adverse cardiac events (MACEs), defined as cardiac death or recurrent acute myocardial infarction (AMI).

Results

Among the 1369 patients followed, 52 experienced MACEs. PNI significantly differed between the MACE and non-MACE groups. The area under the curve (AUC) for PNI was 0.714 (P < 0.001, 95% CI 0.642–0.785). Based on Youden’s index, the optimal PNI cut-off was 46.905. Kaplan-Meier analysis revealed lower cumulative survival in the low PNI group (log-rank P < 0.001). Multivariate Cox regression identified Cr ≥110 µmol/L (HR: 4.353, 95% CI 1.632–11.611, P = 0.003), LVEF ≤40% (HR: 5.646, 95% CI 2.126–14.992, P = 0.001), and PNI <46.905 (HR: 2.822, 95% CI 1.429–5.575, P = 0.003) as independent risk factors. A restricted cubic spline demonstrated that lower PNI is associated with a higher MACE risk.

Conclusion

A PNI of less than 46.905 may serves as an independent prognostic factor for ACS patients post-PCI in our cohort, potentially aiding in identifying high-risk individuals; however, this cutoff requires external validation in broader populations.