High sensitive modified Glasgow prognostic score for predicting ın-hospital mortality ın elderly patients with non-st elevation myocardial infarction

Aim: Inflammation and malnutrition are poor prognostic markers in acute coronary syndromes. In this study, we aimed to investigate the association between high sensitive modified Glasgow prognostic score (HS-mGPS), derived from C-reactive protein and serum albumin levels, and in-hospital mortality of elderly patients with non-ST elevation myocardial infarction (NSTEMI). Material and Methods: Included subjects were recruited from three different tertiary health centers. Totally, 282 eligible patients aged >65 years with diagnosis of NSTEMI were retrospectively enrolled. Global Registry of Acute Coronary Events (GRACE) risk score for in-hospital mortality and HS-mGPS was calculated for each patient. Subjects were categorized according to their inflammation-based scores ((high HS-mGPS group (HS-mGPS ≥1, n=124) vs. low HS-mGPS group (HS-mGPS =0, n=158)). Results: Both groups were similar regarding admission blood pressure levels, coronary angiography findings, treatment modalities and GRACE scores. Patients with high HS-mGPS had higher admission heart rate and longer hospitalization duration compared to low HS-mGPS group. In-hospital mortality rates were higher in high HS-mGPS group compared to low HS-mGPS group (21.8% (n=27) vs. 3.2% (n=5), respectively, P<0.001). GRACE risk score (HR:1.037, 95% CI: 1.009-1.065, P=0.008) and HS-mGPS ≥1 (HR:4.602, 95% CI: 1.581-13.391, P=0.005) were independent predictors of in-hospital mortality. Furthermore, in hospital mortality in HS-mGPS group was significantly higher than low HS-mGPS group in the Kaplan–Meier curve analysis (log rank P < 0.001). Conclusion: High HS-mGPS is independently associated with in-hospital mortality in elderly patients with NSTEMI. Using this inflammation-based simple score could help in more precise risk estimation in elderly patients daily practice.