Влияние прогностического индекса питания на отдаленные результаты реваскуляризации «незащищенного» ствола левой коронарной артерии

Цель    Прогностический нутриционный индекс (PNI) представляет собой практичную прогностическую систему оценки. Однако его клиническое значение у пациентов с «незащищенным» стволом левой коронарной артерией (ЛКА), подвергающихся чрескожному коронарному вмешательству (ЧКВ), еще не выяснено. Это исследование было направлено на изучение взаимосвязи между недостаточностью питания, оцениваемой с помощью PNI, и серьезными неблагоприятными сердечными событиями (MACE) у пациентов с «незащищенным» стволом ЛКА, перенесших ЧКВ.
Материал и методы    В исследование включено 185 госпитализированных пациентов, которым была выполнена коронароангиография, с критическим поражением ЛКА и ЧКВ под ангиографическим контролем. Исследуемая популяция была разделена на терцили на основе значений PNI. Высокий PNI (n = 142) определялся как значение в третьем терциле (≥ 34,0), а низкий PNI (n = 43) определялся как значение в нижних 2 терцилях (< 34,0). Первичной конечной точкой был MACE.
Результаты    Показатели MACE и смертности в группе с низким уровнем PNI были значительно выше по сравнению с группой с высоким уровнем PNI (51% против 30%, p = 0,009; 44% против 20%, p = 0,002 соответственно). Высокий PNI (ОР: 1,902; 95% ДИ: 1,112-3,254; р = 0,019), предшествующий инсульт (ОР: 3,025; 95% ДИ: 1,038-8,810; р = 0,042) и оценка SYNTAX (ОР: 1,028; 95% ДИ): 1,004-1,057, p = 0,023) были независимыми предикторами MACE в многопараметрическом регрессионном анализе Кокса.
Выводы    У пациентов, перенесших ЧКВ «незащищенного» ствола ЛКА, нутриционный статус можно рассматривать как прогностический показатель частоты MACE путем оценки балла PNI. Этот показатель можно использовать для классификации рисков.

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