Comparative Analysis of Three Nutrition Scores in Predicting Mortality after Acute Myocardial Infarction

ABSTRACT Background We investigated the utility of nutrition scores in predicting mortality and prognostic importance of nutrition status using 3 different scoring systems in acute myocardial infarction (AMI) patients. Methods In total, 1,147 AMI patients were enrolled in this study (72.5 % men; mean age 65.6 years). Patients were divided into 3 groups according to the geriatric nutritional risk index (GNRI), prognostic nutrition index (PNI) and triglycerides, total cholesterol and body weight index (TCBI) scores as tertile: low (GNRI≤103.8, n=382), intermediate (103.8 112.3, n=382) GNRI groups; low (PNI≤50.0, n=382), intermediate (50.0 56.1, n=382) PNI groups; low (TCBI≤1086.4, n=382), intermediate (1086.3 2139.1, n=382) TCBI groups. Results In the GNRI, TCBI and PNI groups, the cumulative incidence of all-cause death and major adverse cardiovascular events (MACE) was significantly higher in the low score group, followed by the intermediate and high score groups. Moreover, both intermediate and low PNI groups had a similar cumulative incidence of all-cause death and MACE. The GNRI score (AUC 0.753, 95% CI 0.608∼0.745, p=0.009) had significantly higher areas under the curve (AUCs) than the TCBI (AUC 0.659, 95% CI 0.600∼0.719, reference) and PNI (AUC 0.676, 95% CI 0.608∼0.745, p=0.669) scores. Conclusions Patients with low nutrition score were at a higher risk of MACE and all-cause death than patients with high nutrition score. Additionally, the GNRI had the greatest incremental value in predicting risks among the 3 different scoring systems used in this study.