Prognostic Nutritional Index in Elderly Patients Undergoing Percutaneous Coronary Intervention - The 68th Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Eed Abu-Zaid ^1,3 Omer gluzman ^1,3 Ido Peles ² Yigal Abramowitz ^1,3 Carlos Cafri ^1,3 Gabriel Rosenstein ^1,3 Miri Merkin ^1,3 Doron Zahger ^1,3 Edward Koifman ^1,3

¹Cardiology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer Sheva, Israel, Israel
²Clinical Research Center, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer Sheva, Israel, Israel
³Cardiology, Soroka University Medical Center and Ben-Gurion University of the Negev, Beer Sheva, Israel, Israel

Background
Prognostic nutritional index (PNI) is a validated prognostic tool for the assessment of malnutrition and is associated with adverse outcome in various conditions. In this study we aimed to evaluate the association of PNI score with adverse outcome in elderly patients undergoing percutaneous coronary intervention (PCI).

Methods
We included consecutive patients over 65 years old who underwent PCI in a large tertiary medical center between the years 2005-2018. Study cohort was divided into three equal tertiles, based on PNI score, into normal (PNI>40), moderate (37
Results
A total of 4,833 patients were divided to three tertiels with 1611 patients in each. The lower tertile was characterized by older age (73.8±5.8 vs.74.5±6.3, and 76.1±6.7 in the normal, moderate, and severe groups), and higher rate of renal failure and heart failure compared to both higher PNI groups (p<0.001). Left main disease and multi vessels disease were more frequently found in the severe PNI group compared to the normal and moderate PNI groups (20.2% vs. 14.3% and 16.9%, and 48.8% vs. 42.4% and 44.3% respectively, p<0.001 for both). All-cause mortality rate was significantly higher in the severe PNI group (44.9%) compared to the normal (19.9%) and moderate (26.9%) PNI groups during a 5-years follow-up time as was shown in the Kaplan-Meier survival curves, p<0.001. PNI was found to be an independent risk factor for long-term mortality with HR of 3.04 (95% confidence interval (CI)2.24-4.12; p<0.001) as was found in the adjusted Cox hazard ratio analysis.

Conclusion
Our findings indicate the association between malnutrition, assessed by the PNI score, and adverse outcomes in elderly patients undergoing PCI. More research is needed to evaluate the applicability of PNI as an assessment tool for prognosis in this population.