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Objective <p>To explore the prognostic value of global immune–nutrition–inflammation index (GINI) in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA).</p> Methods <p>A total of 419 patients with MINOCA were consecutively included in the present study. The individuals included were followed up and the major adverse cardiovascular and cerebrovascular events (MACCE) were recorded. Patients were divided into the MACCE group and the control group according to the presence of MACCE. The Cox regression analyses were performed to investigate the independent predictors for the occurrence of MACCE in MINOCA patients. To further evaluate the impacts of different levels of GINI on the presence of MACCE, patients were grouped as tertile 1, tertile 2, and tertile 3 according to the tertiles of GINI.</p> Results <p>Patients with MACCE exhibited increased levels of cardiac troponin I (cTnI) and GINI (<i>P</i> &lt; 0.05). The Cox regression analysis revealed that GINI was an independent predictor for MACCE in patients with MINOCA. As a combined indicator, GINI showed superior predictive performance compared with individual single indicators. Of note, GINI only exhibited modest discriminatory ability with limited sensitivity and specificity at the optimal cut-off value of ≥ 93.99 in this cohort. In addition, when divided into three groups according to the tertiles of GINI, patients in tertile 3 showed a 4.571-fold increased risk of MACCE compared with those in tertile 1 (HR, 4.571; 95% CI 2.285–9.145; <i>P</i> &lt; 0.001).</p> Conclusion <p>A higher level of GINI was associated with an increased risk of MACCE in MINOCA patients. GINI provides a novel research perspective for prognostic risk stratification in MINOCA patients, while its limited predictive accuracy restricts its standalone application in routine clinical practice. Given the limitations of the single-center observational design, relatively small sample size, and lack of subgroup analysis stratified by MINOCA etiology, our findings can only demonstrate associative relationships rather than causal effects. In addition, the current conclusions are restricted to the overall MINOCA population and cannot be extrapolated to specific etiological subtypes. In the future large-scale studies focusing on the prognostic performance of GINI across distinct etiological subtypes of MINOCA are warranted to validate our findings.</p>

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The global immune–nutrition–inflammation index as a potential prognostic biomarker for prognosis in patients with myocardial infarction with non-obstructive coronary arteries: a prospective, single-center, observational study

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  • 发表日期：

    2026年7月9日

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  • Hong-wei Zhao,
  • Cheng-fu Wang

摘要

Objective

To explore the prognostic value of global immune–nutrition–inflammation index (GINI) in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA).

Methods

A total of 419 patients with MINOCA were consecutively included in the present study. The individuals included were followed up and the major adverse cardiovascular and cerebrovascular events (MACCE) were recorded. Patients were divided into the MACCE group and the control group according to the presence of MACCE. The Cox regression analyses were performed to investigate the independent predictors for the occurrence of MACCE in MINOCA patients. To further evaluate the impacts of different levels of GINI on the presence of MACCE, patients were grouped as tertile 1, tertile 2, and tertile 3 according to the tertiles of GINI.

Results

Patients with MACCE exhibited increased levels of cardiac troponin I (cTnI) and GINI (P < 0.05). The Cox regression analysis revealed that GINI was an independent predictor for MACCE in patients with MINOCA. As a combined indicator, GINI showed superior predictive performance compared with individual single indicators. Of note, GINI only exhibited modest discriminatory ability with limited sensitivity and specificity at the optimal cut-off value of ≥ 93.99 in this cohort. In addition, when divided into three groups according to the tertiles of GINI, patients in tertile 3 showed a 4.571-fold increased risk of MACCE compared with those in tertile 1 (HR, 4.571; 95% CI 2.285–9.145; P < 0.001).

Conclusion

A higher level of GINI was associated with an increased risk of MACCE in MINOCA patients. GINI provides a novel research perspective for prognostic risk stratification in MINOCA patients, while its limited predictive accuracy restricts its standalone application in routine clinical practice. Given the limitations of the single-center observational design, relatively small sample size, and lack of subgroup analysis stratified by MINOCA etiology, our findings can only demonstrate associative relationships rather than causal effects. In addition, the current conclusions are restricted to the overall MINOCA population and cannot be extrapolated to specific etiological subtypes. In the future large-scale studies focusing on the prognostic performance of GINI across distinct etiological subtypes of MINOCA are warranted to validate our findings.