Correlation Studies Between Objective Nutritional Indices And Prognosis In Patients With Acute Myocardial Infarction

Objective To evaluate the nutritional states of acute patients with myocardial infarction(AMI)in hospital with two kinds of objective nutritional indices includes controlling nutritional(CONUT)score and prognostic nutritional index(PNI)and to investigate and compare the correlation between objective nutritional indices and prognosis in these patients.Method We performed a monocentric retrospective cohort study in patients with acute myocardial infarction after percutaneous coronary intervention(PCI)and the median follow-up was 36(33,36 interquartile range)months in our center.The endpoit was all cause of death.Information was obtained from hospital discharge and telephone.All the cases were divided into three groups according to the CONUT score: normal(n=304),mild(n=476)and moderate-severe(n=58).The differences of mortality in every groups by CONUT and PNI score were compared with Kaplan-meier.In addition,the relationship of objective nutritional indices and clinical index were analyzed with the Pearson correlation coefficient.The correlation of nutritional states and mortality of AMI patients were analyzed with the Cox proportional hazard analyzes.Results A total of 838 cases were selected and 51 patients were died for all cause of death.A major of patients(63.7%)were in malnutrition state with CONUT score.Kaplan-meier curves indicated that the patients with high CONUT score [Pairwise log-rank 0-1 v.s.2-4 P=0.021,0-1 v.s.5-12 P<0.001],low PNI score[Pairwise log-rank >38 v.s.5-38 P<0.001,>38 v.s.<35 P<0.001]was significantly correlated with mortality.The Cox poportional hazard analyzes revealed that both the CONUT [CONUT=2-4 v.s.CONUT=0-1:HR(95%CI),2.423(1.111-5.286),P=0.026;CONUT=5-12 v.s.CONUT=0-1:HR(95%CI),9.167(3.799-22.120),P<0.001]and PNI[PNI=5-38 v.s.PNI>38:HR(95%CI),3.365(1.674-6.763),P=0.001;PNI<35 v.s.PNI>38:HR(95%CI),6.359(3.359-1.674),P<0.001] score were associated with increased risk of all cause of death in unajusted model.We still have the similar result in CONUT[CONUT=2-4 v.s.CONUT=0-1:HR(95%CI),3.328(1.399-7.919),P=0.007;CONUT=5-12 v.s.CONUT=0-1:HR(95%CI),8.331(2.376-29.211),P=0.001] and PNI [PNI=5-38 v.s.PNI>38:HR(95%CI),1.795(0.751-4.293),P=0.188;PNI<35 v.s.PNI>38:HR(95%CI),3.169(1.545-6.501),P=0.002]which revealed that the CONUT is better than PNI.Conclusions Malnutrition is universal in AMI patients.Objective nutritional indices CONUT score could be a better predictor of mortality in AMI patients than PNI.