Abstract
Introduction: Geriatric nutritional risk index (GNRI) is a simple nutritional assessment tool for elderly patients. Lower GNRI is associated with a worse prognosis in patients with critical limb ischemia or hemodialysis. However, few data are available regarding the prognostic impact of GNRI value for risk stratification in patients with peripheral artery disease (PAD). Hypothesis: We hypothesized that GNRI values would predict adverse cardiovascular (CV) events in patients with PAD. Methods: We retrospectively enrolled 480 consecutive patients with PAD who were hospitalized for CV diseases between 2005 and 2012. GNRI on admission was calculated as follows: 14.89 * serum albumin (g/dL) + 41.7 * body mass index/22. Patients were divided into two groups stratified by GNRI (median value 103.3). The study endpoint was the composite of major adverse cardiovascular events (MACE), including all-cause death, myocardial infarction, and stroke. Results: Over a 3.7-year median follow-up, adverse events were observed in 164 patients (34.2 %). In Kaplan–Meier analysis, patients with low GNRI (< 103.3, n = 239) showed worse prognoses than those with high GNRI (≥ 103.3, n = 241) (MACE incidence 42.7 % vs. 25.7 %, P < 0.001). In multivariate Cox proportional hazards analysis after the adjustment for age, sex, estimated glomerular filtration rate, B-type natriuretic peptide, and left ventricular ejection fraction, Low GNRI (<103.3) was significantly associated with the incidence of MACE (hazard ratio: 2.14, 95% confidence interval: 1.34–3.41; P < 0.001). Conclusions: In patients with PAD, GNRI is an independent predictor of MACE. Simple assessment of GNRI may be useful for predicting CV events in those patients.
Published Version
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