Cut-off values of geriatric nutritional risk index for cardiovascular events in acute myocardial infarction patients

Abstract Low Geriatric Nutritional Risk Index (GNRI) in patients with heart failure is associated with poor prognosis. However, the usefulness of GNRI for patients with acute myocardial infarction (AMI) remains controversial. We evaluated the optimal cut-off values of GNRI for cardiovascular events in AMI patients by time-dependent receiver operating characteristic (ROC) analysis to examine its usefulness. We retrospectively investigated the optimal cut-off values for two endpoints of all-cause death and major adverse cardiac events (MACE: all-cause death, non-fatal myocardial infarction, hospitalization for heart failure, stroke) over 48 months in 360 patients with AMI who required emergency admission to our hospital between January 2012 and February 2020. The cumulative incidence of MACE over 48 months was 11.6%. The cut-off value of GNRI for all-cause death was 82.7 (AUC 0.834) at 3 months, 89.3 (AUC 0.861) at 12 months, and 90.3 (AUC 0.854) at 48 months. The cut-off value of GNRI for MACE was 83.0 (AUC 0.841) at 3 months, 95.7 (AUC 0.863) at 12 months, and 95.3 (AUC 0.821) at 48 months. Time-dependent ROC analysis showed that the optimal cut-off value of GNRI varied over time. The optimal cut-off value of GNRI is a useful predictor for prognosis in patients with AMI.