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Wu TT, Pan Y, Zhi XY, Deng CJ, Wang S, Guo XX, Hou XG, Yang Y, Zheng YY, Xie X. Association between extremely high prognostic nutritional index and all-cause mortality in patients with coronary artery disease: secondary analysis of a prospective cohort study in China. BMJ Open 2024; 14:e079954. [PMID: 38885991 PMCID: PMC11184201 DOI: 10.1136/bmjopen-2023-079954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 05/19/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Decreased prognostic nutritional index (PNI) was associated with adverse outcomes in many clinical diseases. This study aimed to evaluate the relationship between baseline PNI value and adverse clinical outcomes in patients with coronary artery disease (CAD). DESIGN The Personalized Antiplatelet Therapy According to CYP2C19 Genotype in Coronary Artery Disease (PRACTICE) study, a prospective cohort study of 15 250 patients with CAD, was performed from December 2016 to October 2021. The longest follow-up period was 5 years. This study was a secondary analysis of the PRACTICE study. SETTING The study setting was Xinjiang Medical University Affiliated First Hospital in China. PARTICIPANTS Using the 50th and 90th percentiles of the PNI in the total cohort as two cut-off limits, we divided all participants into three groups: Q1 (PNI <51.35, n = 7515), Q2 (51.35 ≤ PNI < 59.80, n = 5958) and Q3 (PNI ≥ 59.80, n = 1510). The PNI value was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). PRIMARY OUTCOME The primary outcome measure was mortality, including all-cause mortality (ACM) and cardiac mortality (CM). RESULTS In 14 983 participants followed for a median of 24 months, a total of 448 ACM, 333 CM, 1162 major adverse cardiovascular events (MACE) and 1276 major adverse cardiovascular and cerebrovascular events (MACCE) were recorded. The incidence of adverse outcomes was significantly different among the three groups (p <0.001). There were 338 (4.5%), 77 (1.3%) and 33 (2.2%) ACM events in the three groups, respectively. A restricted cubic spline displayed a J-shaped relationship between the PNI and worse 5-year outcomes, including ACM, CM, MACE and MACCE. After adjusting for traditional cardiovascular risk factors, we found that only patients with extremely high PNI values in the Q3 subgroup or low PNI values in the Q1 subgroup had a greater risk of ACM (Q3 vs Q2, HR: 1.617, 95% CI 1.012 to 2.585, p=0.045; Q1 vs Q2, HR=1.995, 95% CI 1.532 to 2.598, p <0.001). CONCLUSION This study revealed a J-shaped relationship between the baseline PNI and ACM in patients with CAD, with a greater risk of ACM at extremely high PNI values. TRIAL REGISTRATION NUMBER NCT05174143.
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Affiliation(s)
- Ting-Ting Wu
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University, Ministry of Education), Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ying Pan
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiao-Yu Zhi
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chang-Jiang Deng
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shun Wang
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiao-Xia Guo
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xian-Geng Hou
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yi Yang
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ying-Ying Zheng
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University, Ministry of Education), Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xiang Xie
- Department of Cardiology, Xinjiang Medical University Affiliated First Hospital, No. 137, Liyushan Road, Urumqi, China
- Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University, Ministry of Education), Urumqi, China
- Key Laboratory of Hypertension Research of Xinjiang Medical University, Urumqi, Xinjiang, China
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Cevher Akdulum MF, Demirdağ E, Arık Sİ, Safarova S, Erdem M, Bozkurt N, Erdem A. Is the First-Trimester Systemic Immune-Inflammation Index Associated With Preeclampsia? Cureus 2023; 15:e44063. [PMID: 37746374 PMCID: PMC10517744 DOI: 10.7759/cureus.44063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE Preeclampsia (PE) is a serious and common pregnancy issue. There is a systemic inflammation in PE and it is accompanied by increased oxidative stress, but the clear etiology has not been revealed. We aimed to predict PE with the systemic immune-inflammation index (SII) value calculated in the first trimester. MATERIAL AND METHODS This is a retrospective study. One hundred fifty-seven pregnant women were included in the study. Twenty-seven pregnant women were excluded from the study. Age, gravida, parity, and hemogram values were recorded in the patients' first visit file records. The time and mode of delivery, birth weight, and APGAR scores were obtained from the file records of the patients. SII was created using the formula (neutrophil x platelet/lymphocyte). Result: The study group included 30 pregnant women who had been diagnosed with PE. The control group consisted of the remaining 100 pregnant women. There was a statistically significant difference between PE and control groups in terms of SII (p=0.03). The SII level cut-off value for predicting PE was determined to be 836.83. This value's area was found to be 0.635 (0.519-0.752). Furthermore, the selectivity is 0.60 and the sensitivity is 0.40 for these values. Conclusion: SII was found to be significantly higher in people with PE in the study. We showed that the SII value measured in the first trimester can be used to predict PE. It might make sense to combine this marker with the patient's history and other risk factors due to its low selectivity and sensitivity.
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Affiliation(s)
| | | | | | | | - Mehmet Erdem
- Obstetrics and Gynecology, Gazi University, Ankara, TUR
| | - Nuray Bozkurt
- Obstetrics and Gynecology, Gazi University, Ankara, TUR
| | - Ahmet Erdem
- Obstetrics and Gynecology, Gazi University, Ankara, TUR
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Cai J, Chen C, Zhang L, Zhai X, Zhao X, Ge J, Chang X, Song B, Qu X. The association between the prognostic nutritional index and 28-day mortality among atrial fibrillation patients in China over 80 years of age. Nutr Metab Cardiovasc Dis 2022; 32:1493-1501. [PMID: 35461750 DOI: 10.1016/j.numecd.2022.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/15/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUNDS AND AIMS The most prevalent form of cardiac rhythm abnormality among older populations is atrial fibrillation (AF). The prognostic nutritional index (PNI) is a reliable predictor of mortality in various diseases. The association between the PNI and mortality among AF patients over 80 years remains uncleared. METHODS AND RESULTS A retrospective assessment of AF cases admitted to a single cardiovascular disease unit in China between January 2015 and June 2020 was performed. The PNI at admission was defined as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). The association between PNI and cardiovascular disease (CVD)-related or all-cause mortality within 28 days was assessed via multivariable Cox regression. The analysis included 1141 patients. The CVD-related and all-cause mortality rates were 3.3% and 8.7%. Kaplan-Meier analyses revealed that cases with lower PNI tertiles exhibited higher all-cause mortality (T1: 7.6%; T2: 6.1%; T3: 2.4%, P < 0.001) or CVD mortality (T1: 6.3%; T2: 2.9%; T3: 0.8%, P < 0.001). After adjusting for potential confounders, continuous PNI was negatively related to the hazard of all-cause mortality (HR 0.92, 95% CI 0.89, 0.96) and CVD-related mortality (HR 0.90, 95% CI 0.84, 0.95). Compared to the T1 group, patients with a higher PNI exhibited a lower risk of all-cause mortality (P for trend 0.003) and CVD-related mortality (P for trend 0.005). Among most subgroups, CVD-related and all-cause mortality decreased with elevating PNI values. CONCLUSIONS PNI is significantly negatively correlated with CVD-related and all-cause mortality among AF cases over 80 years.
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Affiliation(s)
- Jiasheng Cai
- Departments of Cardiology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai, 200040, China.
| | - Conggai Chen
- Department of Neurology, Second Xiangya Hospital, Central South University, 139 Renmin Middle Road Changsha 410011 China.
| | - Lingyun Zhang
- Department of Nephrology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai 200040, China.
| | - Xinrong Zhai
- Departments of Cardiology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai, 200040, China.
| | - Xiaona Zhao
- Departments of Cardiology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai, 200040, China.
| | - Jin Ge
- Department of General Medicine, Renji Hospital affiliated to JiaoTong University, 1630 Pujian Road Shanghai 200127, China.
| | - Xifeng Chang
- Departments of Cardiology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai, 200040, China.
| | - Bin Song
- Department of Chronic Diseases Management, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou 225001, China.
| | - Xinkai Qu
- Departments of Cardiology, Huadong Hospital affiliated to Fudan University, 221 Yanan West Road Shanghai, 200040, China.
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Yılmaz F, Keleş M, Bora F. Relationship between the prognostic nutritional index and resistant hypertension in patients with essential hypertension. Clin Exp Hypertens 2022; 44:326-333. [PMID: 35180826 DOI: 10.1080/10641963.2022.2036995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Immune system activation plays a role in resistant hypertension (RHTN) pathogenesis. The clinical effect of the prognostic nutritional index (PNI) on patients with RHTN remains unclear. The aim of this study investigated the possible correlation between PNI and RHTN. METHODS In this cross-sectional study, we enrolled 180 adult subjects. In patients were classified into three groups according to their office and ambulatory blood pressure measurements (ABPM): RHTN (n = 60), controlled hypertension (CHTN, n = 60), and normotension-control (NT-C, n = 60). RHTN was defined as BP ≥140/90 mm Hg while taking ≥3 antihypertensive medications or BP <140/90 mm Hg while taking ≥4 medications. The PNI was calculated from the 10 x serum albumin (g/dL) + 0.005 x total lymphocyte count (/μL) formula. RESULTS Office and ABPM were significantly higher in patients with RHTN. Patients in the RHTN (46.1 ± 5.3) had significantly lower PNI than that in the CHTN (54.9 ± 6.7) (P = .032), and PNIs of both hypertensive groups were significantly lower than the NT-C group (P = .019, for both). The ROC curve analysis performed to assess the predictive value of PNI for RHTN and using 50.9 optimal cutoff value of PNI for RHTN gave a sensitivity of 77% and a specificity of 68.5% (AUC = 0.73, 95% CI 0.69-0.96).Multivariate analysis indicated diabetes, 24-h ABPM SBP, CRP, pill burden, and PNI (<51.6) as independent predictors of RHTN. CONCLUSION This study showed that the level of PNI was significantly lower in patients with RHTN compared to patients with CHTN. PNI is independently related to RHTN.
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Affiliation(s)
- Fatih Yılmaz
- Department of Nephrology, Antalya Atatürk State Hospital, Antalya, Turkey
| | - Meryem Keleş
- Department of Nephrology, Ankara City Hospital, Ankara, Turkey
| | - Feyza Bora
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medicine of Faculty, Antalya, Turkey
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