Роль прогностического нутриционного индекса у пациентов с острым коронарным синдромом без подъема сегмента ST

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.

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