Prognostic Nutritional Index Predicts Clinical Outcome In Patients With Acute ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Objective: To investigate whether the combined nutritional-inflammatory PNI score is associated with all-cause mortality after primary percutaneous coronary intervention(pPCI) in patients with acute ST-segment elevation myocardial infarction(STEMI). Design: From September 2011 to November 2014, 309 consecutive patients with STEMI undergoing pPCI in the First Affiliated Hospital of Xinjiang Medical University were prospectively evaluated. Patients with a combined albumin(g/L) + 5×total lymphocyte count×109/L ≥45 or <45 were assigned a PNI score of 0 or 1, respectively. PNI, as a predictor of mortality as a primary outcome, and cumulative survival according to PNI were investigated using multivariable Cox regression and Kaplan-Meier analyses, respectively. Results: Of the 309 STEMI patients, 24(7.74%) died in the hospital, and 15(4.83%) died during follow-up, which had a median length of 19.5 months. Patients with a PNI of 1 relative to patients with a PNI of 0 had significantly higher rates of in-hospital and follow-up death and a lower cumulative survival rate(all P<0.001). PNI(1/0, hazard ratio, 2.645; 95% confidence interval, 1.199 to 5.832; P=0.016) was a significant independent predictor of mortality in patients with STEMI undergoing pPCI. Conclusions: PNI appears useful for risk stratification of pPCI treated STEMI patients.