The Predictive Value Of GNRI In The Severity Of Vascular Lesions And Prognostic Value In Acute St-segment Elevation Myocardial Infarction

Purpose:To investigate the value of GNRI in the severity of vascular lesions and prognostic value in STEMI patients.To compare association of the GNRI levels in single-branch,double-branch,and three-branch lesions of the STEMI patients.To determine the correlation between GNRI and different Gensini score groups,and then to determine the correlation between GNRI and the severity of coronary artery disease.To assure whether there is difference between GNRI and the MACE after follow up for 1year in STEMI patients.Methods:Our study enrolled 168 patients who were diagnosed as STEMI by cardiology department and coronary angiography in North of Jiangsu People’s hospital due to chest pain from October 2015 to October 2017.22 patients were lost during follow-up,and the remaining 146 were aged between 37 and 87 years old,with an average age of62.21±0.93 years old,including 114 males and 32 females.According to the number of vascular lesions,the patients were divided into three groups:single branch lesion with53 patients;double branch lesions with 47 patients;three branch lesions with 46 patients.There were three groups according to the Gensini score:Low GNRI≤40,GNRI between 41 and 63;GNRI≥64.Compared the relationship between GNRI and the lesion count and Gensini score.All these patients were followed up for 1 year.Results:(1)The GNRI level in three branch lesions group(107.32±10.63)was significantly lower than that single branch lesion group(114.64±11.56),and the difference was statistically significant.(2)The GNRI level in double branch lesions group(108.23±10.00)was significantly lower than that in single branch lesion group(114.64±11.56).(3)There was no significant difference in GNRI level between the three branch lesions group(107.32±10.63)and the double branch lesions group(108.23±10.00).(4)The GNRI level in Gensini≤40 group(114.47±11.18)was significantly higher than that in Gensini ≥64 group(109.18±11.21).(5)The GNRI level in the Gensini≤40 group(114.47±11.18)was significantly higher than that in the 40 <Gensini < 64 group(108.79±10.70).(6)There was no significant difference in GNRI level between the group with 40 < Gensini < 64(108.79±10.70)and the group with GNRI≥64(109.18±11.21).(7)There was no significant difference in GNRI between the MACE group(109.57±13.61)and the non-MACE group(110.59±10.05)(P > 0.05).Conclusion:The GNRI level in STEMI patients with single branch lesion group was significantly higher than that in double and three branch lesions group,suggesting that the GNRI level showed a downward trend as the number of vascular lesion increased.Similar results were found in different Gensini score groups.Thus,we conclude that the GNRI level is an important predictor of the severity of coronary artery disease.After 1-year follow-up,we find that there was no significant difference in GNRI level between MACE patients and non-MACE patients.