The Prognostic Impact Of Objective Nutritional Indices In Elderly Patients With St-Elevation Myocardial Infarction Undergoing Primary Coronary Intervention

Background: The prognostic impact of nutritional status in ST-elevation myocardial infarction (STEMI) patients is poorly understood.Methods: We used the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) score on outcomes of 945 patients with acute STEMI undergoing primary percutaneous coronary intervention with stent.Results: During a median follow-up of 2 years (1-3.3 years, interquartile range), 56 patients (5.9%) died for all-cause of death. In the dead group, the CONUT and PNI scores were more severe than in the alive group. Elderly patients (>= 71 years) had nutritional indices more serious than patients <71 years. In the whole population of the study, both CONUT and PNI correlated with clinical markers of poor prognosis such as brain natriuretic peptide (BNP), creatinine and liver enzymes. Kaplan-Meier curves revealed that the patients with severe CONUT but not patients with severe PNI index had the highest event rate for all-cause death, with a log-rank of p < 0.001. The Cox proportional hazard analyses showed that, contrary to PNI score, the CONUT score was associated with increased risk of all-cause death for both unadjusted model and age-and sex-adjusted model, while in a full-adjusted model the best predictors were age and BNP.Conclusions: In STEMI patients, the nutritional status evaluated by the CONUT score, in addition to other comorbidities, can affect the prognosis in elderly patients. These results suggest a personalized nutritional treatment as well as an accurate assessment of the appropriateness of lipid-lowering treatment after coronary revascularization. (C) 2016 Elsevier Ireland Ltd. All rights reserved.