老年营养风险指数对非ST段抬高型急性冠状动脉综合征病人经皮冠状动脉介入术后院内主要心血管不良事件的预测价值

目的 探讨老年营养风险营养指数（GNRI）对非ST段抬高型急性冠状动脉综合征（NSTE-ACS）病人经皮冠状动脉介入术（PCI）后发生院内主要心血管不良事件（MACE）的预测价值。方法 回顾性收集2019年12月至2021年6月徐州医科大学附属医院收治的经PCI治疗的NSTE-ACS病人360例，根据病人术后是否发生MACE，分为MACE组48例和非MACE组312例。比较两组间临床资料、实验室检查结果的区别。应用多因素logistic回归分析评估发生MACE的危险因素。应用受试者操作特征（ROC）曲线及Delong检验评估GNRI，全球急性冠状动脉事件注册积分（Grace评分）对MACE的预测价值及差异。结果与非MACE组相比，MACE组年龄（75.50±5.37）岁、Grace评分（168.00±32.50）分显著高于非MACE组（69.95±5.21）岁、（139.02±22.59）分，GNRI(95.97±7.33)显著低于非MACE组（103.75±10.47）(P<0.05)。多因素logistic回归分析显示，低GNRI、Grace评分增加及年龄增加是NSTE-AC...

Predictive value of the Geriatric Nutritional Risk Index for in-hospital major adverse cardiovascular events after PCI in patients with NSTE-ACS

Objective To investigate the predictive value of the geriatric nutritional risk index (GNRI) on the occurrence of in-hospital major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).Methods A total of 360 patients with NSTE-ACS treated by PCI admitted to the AffiliatedHospital of Xuzhou Medical University from December 2019 to June 2021 were retrospectively collected and divided into the MACEgroup (n=48) and the non-MACE group (n=312) according to whether the patients had MACE after the procedure. The differences inclinical data and laboratory test results were compared between the two groups. Multivariate logistic regression analysis was applied toevaluate the risk factors for the occurrence of MACE. Receiver operating characteristic (ROC) curve and Delong method were used toevaluate the predictive value and difference of GNRI, Global Registry of Acute Coronary Events score (Grace score) on MACE.Results Compared with the non-MACE group, the MACE group had a significantly higher age (75.50±5.37) and Grace score (168.00±32.50) than the non-MACE group (69.95±5.21 and 139.02±22.59, respectively) and a significantly lower GNRI (95.97±7.33) than the non-MACE group (103.75±10.47) (P<0.05). Multivariate logistic regression analysis showed that low GNRI, increasing GRACE score and increasing age were risk factors for the development of MACE in patients with NSTE-ACS (P<0.05). ROC analysis showed that the area under the curve for the GNRI, GRACE score and both combined to predict the occurrence of MACE was 0.74, 0.77, and 0.81 (P<0.05), respectively. Further comparison of the ROC curves for the GNRI and Grace score using the Delong method showed no statistically significant difference (Z=0.73, P=0.468).Conclusion The GNRI is an important influencing factor for the occurrence of in-hospital MACE,and the preoperative GNRI level has predictive value for the occurrence of in-hospital MACE after PCI in patients with NSTE-ACS.