A novel and simply calculated nutritional index serves as a useful prognostic indicator in patients with coronary artery disease. (1st July 2018)

• Record Type: Journal Article
• Authors: Doi, Shinichiro; Iwata, Hiroshi; Wada, Hideki; Funamizu, Takehiro; Shitara, Jun; Endo, Hirohisa; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Dohi, Tomotaka; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Miyauchi, Katsumi; Daida, Hiroyuki
• Is Part Of: International journal of cardiology. Volume 262(2018)
• Page Start: 92
• Page End: 98
• Publication Date: 2018-07-01
• Subjects: Nutritional index -- Prognosis -- Coronary artery disease; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.02.039
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Objective: No nutritional index has been firmly established yet in patients with coronary artery disease (CAD). In this study, we propose a simple to calculate nutritional indicator in patients who underwent percutaneous coronary intervention (PCI) by using parameters routinely measured in CAD and evaluated its prognostic implication. Methods: This study is a retrospective observational analysis of a prospective database. The subjects were consecutive 3567 patients underwent their first PCI between 2000 and 2013 at Juntendo University Hospital in Tokyo. The median of the follow-up period was 6.3 years (range: 0–13.6 years). The novel nutritional index was calculated by the formula; Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI) = TG × TC × BW / 1000 (TG and TC: mg/dl, and BW: kg). Results: The Spearman non-parametric correlation coefficient between TCBI and the most often used conventional nutritional index, Geriatric Nutritional Risk Index (GNRI), was 0.355, indicating modest correlation. Moreover, Unadjusted Kaplan-Meier analysis showed higher all-cause mortality, cardiovascular mortality, and cancer mortality in patients with low TCBI. Consistently, elevation of TCBI was associated with reduced all-cause (hazard ratio: 0.86, 95%CI: 0.77–0.96, p < 0.001), cardiovascular (0.78, 0.66–0.92, p = 0.003), and cancer mortality (0.76, 0.58–0.99, p = 0.041) in patients after PCI by multivariate Cox proportional hazard analyses. Conclusion: TCBI, a novel and easy to calculate nutrition index, is a useful prognostic indicator in patients with CAD. Highlights: High prognostic impact of nutritional status in cardiovascular disease is recognized. However, no nutritional index has yet to become firmly established due to complexity to calculate. This study introduces a novel nutritional index, simply calculable by serum triglycerides, total cholesterol and body weight. Prognostic implication of this novel nutritional index in patients with coronary artery disease is also demonstrated.