cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2021.1.n1254cardio-1254Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESРоль прогностического нутриционного индекса у пациентов с острым коронарным синдромом без подъема сегмента STThe role of prognostic nutritional index in patients with non-ST segment elevation acute coronary syndromehttps://orcid.org/0000-0003-2900-2926Демирташ ИнджиСаадетDemirtas InciSaadet

Д.м.н., кардиолог

M.D, Cardiologist

saadet_demirtas@yahoo.comСунманХамзаSunmanHamza

Доцент, кардиолог

Associate Professor, Cardiologist

hamzasunman@gmail.comОзкан ИбисАйсенурNur Ozkaya IbisAyse

Д.м.н., кардиолог

M.D, Cardiologist

dr.aysenur.ozkaya@gmail.comАйрзурумМухаммедErzurumMuhammed

Д.м.н., кардиолог

M.D, Cardiologist

muhammederzurum42@gmail.comОзбеязНайль БуракÖzbeyazNail Burak

Д.м.н., кардиолог

M.D, Cardiologist

drozbeyaz@gmail.comАльгюльЭнгинAlgülEngin

Д.м.н., кардиолог

M.D, Cardiologist

algulengin@gmail.comГундузЯсеминGündüzYasemin

Доцент, радиолог

Associate Professor, Radiologist

dryasemingunduz@yahoo.comАйкян ПомукджуХилалErken PamukcuHilal

Д.м.н., кардиолог

MD, Cardiologist

hilalerkenn@gmail.comГайетлиКадиеGayretliKadriye

Д.м.н., кардиолог

MD, Cardiologist

kgayretli@hotmail.comСаханХюлук ФурканSahanHaluk Furkan

Д.м.н., кардиолог

MD, Cardiologist

halukfurkan@gmail.comМедицинский Университет, Научно-образовательный госпиталь им. Дискапи Юрди-лим Бездит, Анкара, ТурцияТурцияCardiology Department, Health Sciences University, Diskapi Yildirim Beyazid Education and Research Hospital, Ankara, TurkeyTurkey2021100220216115965Copyright © Kardiomag, 20212021KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1254

Цель Важность статуса питания при остром коронарном синдроме без подъема сегмента ST (ОКСбпST) неясна. В этом исследовании важность прогностического нутриционного индекса (ПНИ) с точки зрения вну-трибольничной смертности у пациентов с ОКСбпST, оцениваемой по шкале Global Record of Acute Coronary Events (GRACE).Материал и методы Ретроспективно были зарегистрированы в общей сложности 498 последовательных пациентов с ОК-СбпST. Для оценки нутритивного статуса пациентов был расчитан ППИ. ППИ рассчитывали как 10 × сыворо-точный альбумин (г/дл) + 0,005 × общее количество лимфоцитов (на мм3). Была оценена связь между индек-сом риска ППИ и GRACE.Результаты Пациенты были разделены на 3 группы: группу низкого риска (≤108 баллов, n=222), группу среднего риска (109-140 баллов, n=161) и группу высокого риска (>140 баллов, n=115) в соответствии с коли-чеством баллов по шкале GRACE. Среднее значение ППИ оказалось самым низким в группе высокого риска по сравнению с другими группами риска. Обнаружилась значимая отрицательная корреляция между оценкой риска по шкале GRACE и ППИ (p <0,001). В многофакторном анализе ППИ выступал в качестве предиктора летальности в стационаре, независимо от оценки риска по шкале GRACE (ОР=0,909; 95% ДИ: 0,842-0,981; p=0,01). Было установлено, что значение ППИ в группе высокого риска внутрибольничной летальности имеет значительную прогностическую способность (AUC=0,710; ДИ: 0,61-0,80; P <0001).Выводы Оценка ППИ - полезный и простой метод оценки состояния питания пациентов с ОКСбпST. Наше исследование предполагает, что ППИ в значительной степени связан с внутрибольничной летальностью и оценкой риска по шкале GRACE у пациентов с ОКСбпST. Это исследование является основой для новых ис-следований, направленных на изучение того, вносит ли ППИ дополнительный прогностический фактор в оценку по шкале GRACE.

Objective The importance of nutritional status in non-ST segment elevated acute coronary syndrome (NSTE-ACS) is not clear. In this study, the importance of prognostic nutritional index (PNI) in terms of in-hospital mortality in patients with NSTE-ACS and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods A total of 498 consecutive NSTE-ACS patients were recorded retrospectively. PNI for nutritional status assessment of patients with NSTE-ACS. PNI was calculated as 10 × serum albumin (g / dL) + 0.005 × total lymphocyte count (per mm3). The association between PNI and GRACE risk score was assessed.Results Patients were classified as low-risk group (≤108 points, n=222), medium-risk group (109–140 points, n=161) and high-risk group (>140 points, n=115) according to the GRACE score. The mean PNI value was found to be the lowest in the high-risk group compared to other risk groups. There was a significant negative correlation between GRACE risk score and PNI (p<0.001). In multivariate analysis, PNI resulted as a predictor of in-hospital mortality independent of GRACE risk score (OR=0.909; 95 % CI: 0.842–0.981; p=0.01). PNI value in the high risk group for in-hospital mortality was determined to have significant predictive ability (AUC=0.710; 95 % CI: 0.61–0.80; p<0001).Conclusions PNI evaluation is a useful and easy method to evaluate the nutritional status of patients with NSTE-ACS. Our study suggests that the PNI is significantly associated with in-hospital mortality, and GRACE risk score in patients with NSTE-ACS. This study is the basis for new studies to investigate whether PNI contributes additional prognostic to the GRACE risk score.

Прогностический нутриционный индексострый коронарный синдром без подъема сегмента ST (ОКСбпST)внутрибольничная смертностьPrognostic nutritional indexnon-ST segment elevated acute coronary syndrome (NSTE-ACS)in-hospital mortalityКонфликт интересов не заявлен.No conflict of interest is reported.ReferencesBraunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients With Unstable Angina). Journal of the American College of Cardiology. 2002;40(7):1366–74. DOI: 10.1016/s0735-1097(02)02336-7Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS et al. 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The authors declare that there are no conflicts of interest present.