P1956Geriatric nutritional risk index as predictor for long-term survival and cardiovascular or limb events in peripheral arterial disease patients

Abstract

Abstract Background The geriatric nutritional risk index (GNRI) is a simple tool to assess the nutritional risk and associated with mortality. However, there are no reports focusing GNRI in peripheral artery disease (PAD) patients. Purpose The purpose of this study was to examine the effects of GNRI for long-term survival, cardiovascular and limb events in PAD patients. Methods A prospective cohort study was performed in 1219 PAD patients. Baseline GNRI was calculated from serum albumin level and body-mass-index. The patients were divided into four groups by GNRI level (G1: >98; G2: 92–98; G3: 82–91; G4: <82). The endpoints were overall survival (OS) and freedom from major adverse cardiovascular and limb events (MACE and MACLE). Results The median follow-up was 73 months. There were 626 deaths (51.4%) during follow-up. The rate of cardiovascular death among dead was 51.3%. The OS rates markedly depended on GNRI level (p<0.01). The 5-year OS rates were G1: 80.8%, G2: 62.0%, G3: 40.0%, G4: 23.3%, respectively. In multivariate analyses, GNRI, age, low ankle brachial pressure index (ABI), low estimated glomerular filtration rate (eGFR), and high C-reactive protein (CRP) levels were independent factors associated with OS (<0.05). GNRI, age, low ABI, diabetes mellitus, coronary artery disease, lower eGFR and higher CRP levels were associated with MACE and MACLE (p<0.05, respectively). Besides, statins improved OS, MACE, and MACLE (<0.01, respectively). Conclusions GNRI was an independent predictor for OS, MACE, and MACLE in PAD patients. Furthermore,statins improved OS, MACE and MACLE in patients with PAD.