{"title":"使用临床虚弱量表和老年营养风险指数对经皮冠状动脉介入治疗后患者的预后分层：SAKURA PCI2抗血栓登记的亚分析","authors":"Masatsugu Miyagawa, Nobuhiro Murata, Riku Arai, Keisuke Kojima, Michiaki Matsumoto, Naoya Matsumoto, Tomoyuki Morikawa, Wataru Atsumi, Eizo Tachibana, Hironori Haruta, Takaaki Kogo, Yasunari Ebuchi, Kazumiki Nomoto, Masaru Arai, Ken Arima, Takashi Mineki, Yutaka Koyama, Koji Oiwa, Yasuo Okumura","doi":"10.1016/j.jjcc.2025.06.006","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although clinical frailty and nutritional status are associated with adverse events in patients after percutaneous coronary intervention (PCI), those two factors are closely interrelated. This study evaluated the prognostic utility of the Geriatric Nutritional Risk Index (GNRI), a nutritional risk assessment tool, in stratifying outcomes in patients with and without frailty.</p><p><strong>Methods: </strong>We used data from a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) from June 2020 until September 2022. This study included 973 patients who underwent PCI [age: 72 (61, 79) years] and had available data. The patients were stratified into four groups based on the Clinical Frailty Scale (CFS) scores (CFS ≥4 defined as vulnerable frailty) and GNRI values (GNRI <92 defined as a high nutritional risk).</p><p><strong>Results: </strong>Of the total patients, 67 (6.9 %) had vulnerable frailty and GNRI <92, 115 (11.8 %) vulnerable frailty and GNRI ≥92, 98 (10.1 %) non-frailty and GNRI <92, and 693 (71.2 %) non-frailty and GNRI ≥92. During a median follow-up of 737 (565-956) days, a Kaplan-Meier curve revealed that patients with a GNRI <92 had higher rates of composite adverse events, including all-cause death, non-fatal myocardial infarctions, stent thromboses, hospitalizations for heart failure, Bleeding Academic Research Consortium 3 or 5 bleeding events, strokes, and venous thromboembolisms, regardless of the frailty status (log-rank, p < 0.05 for both). After adjusting for potential confounding factors, the vulnerable frailty group with a GNRI <92 had the highest composite adverse event rates, with a hazard ratio of 2.51 (95 % confidence interval 1.59-3.95, p < 0.001) compared to the non-frailty group with a GNRI ≥92.</p><p><strong>Conclusions: </strong>Both frailty and malnutrition were significantly linked to adverse outcomes in post-PCI patients, with malnutrition exerting an influence regardless of the frailty status. The GNRI, in particular, served as a valuable prognostic tool, enhancing the risk stratification among frail patients following PCI.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic stratification using the clinical frailty scale and geriatric nutritional risk index in patients after percutaneous coronary intervention: Sub-analysis of the SAKURA PCI2 antithrombotic registry.\",\"authors\":\"Masatsugu Miyagawa, Nobuhiro Murata, Riku Arai, Keisuke Kojima, Michiaki Matsumoto, Naoya Matsumoto, Tomoyuki Morikawa, Wataru Atsumi, Eizo Tachibana, Hironori Haruta, Takaaki Kogo, Yasunari Ebuchi, Kazumiki Nomoto, Masaru Arai, Ken Arima, Takashi Mineki, Yutaka Koyama, Koji Oiwa, Yasuo Okumura\",\"doi\":\"10.1016/j.jjcc.2025.06.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although clinical frailty and nutritional status are associated with adverse events in patients after percutaneous coronary intervention (PCI), those two factors are closely interrelated. This study evaluated the prognostic utility of the Geriatric Nutritional Risk Index (GNRI), a nutritional risk assessment tool, in stratifying outcomes in patients with and without frailty.</p><p><strong>Methods: </strong>We used data from a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) from June 2020 until September 2022. This study included 973 patients who underwent PCI [age: 72 (61, 79) years] and had available data. The patients were stratified into four groups based on the Clinical Frailty Scale (CFS) scores (CFS ≥4 defined as vulnerable frailty) and GNRI values (GNRI <92 defined as a high nutritional risk).</p><p><strong>Results: </strong>Of the total patients, 67 (6.9 %) had vulnerable frailty and GNRI <92, 115 (11.8 %) vulnerable frailty and GNRI ≥92, 98 (10.1 %) non-frailty and GNRI <92, and 693 (71.2 %) non-frailty and GNRI ≥92. During a median follow-up of 737 (565-956) days, a Kaplan-Meier curve revealed that patients with a GNRI <92 had higher rates of composite adverse events, including all-cause death, non-fatal myocardial infarctions, stent thromboses, hospitalizations for heart failure, Bleeding Academic Research Consortium 3 or 5 bleeding events, strokes, and venous thromboembolisms, regardless of the frailty status (log-rank, p < 0.05 for both). After adjusting for potential confounding factors, the vulnerable frailty group with a GNRI <92 had the highest composite adverse event rates, with a hazard ratio of 2.51 (95 % confidence interval 1.59-3.95, p < 0.001) compared to the non-frailty group with a GNRI ≥92.</p><p><strong>Conclusions: </strong>Both frailty and malnutrition were significantly linked to adverse outcomes in post-PCI patients, with malnutrition exerting an influence regardless of the frailty status. The GNRI, in particular, served as a valuable prognostic tool, enhancing the risk stratification among frail patients following PCI.</p>\",\"PeriodicalId\":15223,\"journal\":{\"name\":\"Journal of cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jjcc.2025.06.006\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jjcc.2025.06.006","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Prognostic stratification using the clinical frailty scale and geriatric nutritional risk index in patients after percutaneous coronary intervention: Sub-analysis of the SAKURA PCI2 antithrombotic registry.
Background: Although clinical frailty and nutritional status are associated with adverse events in patients after percutaneous coronary intervention (PCI), those two factors are closely interrelated. This study evaluated the prognostic utility of the Geriatric Nutritional Risk Index (GNRI), a nutritional risk assessment tool, in stratifying outcomes in patients with and without frailty.
Methods: We used data from a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) from June 2020 until September 2022. This study included 973 patients who underwent PCI [age: 72 (61, 79) years] and had available data. The patients were stratified into four groups based on the Clinical Frailty Scale (CFS) scores (CFS ≥4 defined as vulnerable frailty) and GNRI values (GNRI <92 defined as a high nutritional risk).
Results: Of the total patients, 67 (6.9 %) had vulnerable frailty and GNRI <92, 115 (11.8 %) vulnerable frailty and GNRI ≥92, 98 (10.1 %) non-frailty and GNRI <92, and 693 (71.2 %) non-frailty and GNRI ≥92. During a median follow-up of 737 (565-956) days, a Kaplan-Meier curve revealed that patients with a GNRI <92 had higher rates of composite adverse events, including all-cause death, non-fatal myocardial infarctions, stent thromboses, hospitalizations for heart failure, Bleeding Academic Research Consortium 3 or 5 bleeding events, strokes, and venous thromboembolisms, regardless of the frailty status (log-rank, p < 0.05 for both). After adjusting for potential confounding factors, the vulnerable frailty group with a GNRI <92 had the highest composite adverse event rates, with a hazard ratio of 2.51 (95 % confidence interval 1.59-3.95, p < 0.001) compared to the non-frailty group with a GNRI ≥92.
Conclusions: Both frailty and malnutrition were significantly linked to adverse outcomes in post-PCI patients, with malnutrition exerting an influence regardless of the frailty status. The GNRI, in particular, served as a valuable prognostic tool, enhancing the risk stratification among frail patients following PCI.
期刊介绍：
The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
