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Prognostic nutritional index as the predictor of long‐term mortality among HFrEF patients with ICD
Author(s) -
Çinier Göksel,
Hayıroğlu Mert İlker,
Pay Levent,
Yumurtaş Ahmet Çağdaş,
Tezen Ozan,
Eren Semih,
Kolak Zeynep,
Çetin Tuğba,
Özcan Serhan,
Türkkan Ceyhan,
Özbilgin Nazmiye,
Tekkeşin Ahmet İlker,
Alper Ahmet Taha,
Gürkan Kadir
Publication year - 2021
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.14170
Subject(s) - medicine , hazard ratio , ejection fraction , heart failure , confidence interval , proportional hazards model , cardiology , quartile , etiology , cohort
Background The benefit of implantable cardiac defibrillator (ICD) in patients with heart failure and reduced ejection fraction (HFrEF) could be limited in a particular group of patients. Low prognostic nutritional index (PNI) indicates malnutrition and proinflammatory condition. We sought to investigate the value of PNI in predicting long‐term mortality among HFrEF patients with ICD. Methods Electronic database was searched for identifying patients with HFrEF who were implanted ICD in our institution between 2009 and 2019. Demographic and clinical characteristics of included patients were recorded. PNI was calculated according to the formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm 3 ). Patients were divided into the quartiles according to PNI values. Differences between the groups were analyzed by the log‐rank test. A forward Cox proportional regression model was used for multivariable analysis. Results One thousand and hundred patients were included to the study. The underlying heart failure etiology was ischemic and nonischemic in 77.3% and 22.7% of patients, respectively. Mortality rate in Q1 (5.1%) was considered as the reference. In the unadjusted model the mortality rate was 9.5% (hazard ratio [HR] 1.76, 95% confidence interval [95% CI] [0.92‐3.38]) in Q2, 10.2% (HR 1.88, 95% CI 0.99‐3.58) in Q3, and 39.6% (HR 8.12, 95% CI 4.65‐14.17) in Q4. The same trend was consistent in the age‐ and sex‐adjusted, comorbidities‐adjusted, and covariates‐adjusted models. Conclusion Among patients who were implanted with ICD secondary to HFrEF, lower PNI value predicted all‐cause mortality during long‐term follow‐up. This is the first study demonstrating the value of PNI in this population.