Int J Gen Med. 2026 Apr 18;19:603394. doi: 10.2147/IJGM.S603394. eCollection 2026.
ABSTRACT
OBJECTIVE: Current evidence indicates that nutrition plays an important role in cardiovascular disease risk monitoring and prognosis assessment. Therefore, this study aimed to evaluate the correlation between the prognostic nutritional index (PNI) and major adverse cardiovascular events (MACE) in patients with triple - vessel coronary heart disease (TV - CHD).
METHODS: In this single - center retrospective cohort study, 547 patients with TV - CHD admitted to Liaocheng People's Hospital from January 2020 to January 2023 were enrolled. Univariate and multivariate Cox regression analyses, subgroup and sensitivity analyses, receiver operating characteristic (ROC) curve analysis, and Kaplan - Meier survival analysis were performed to assess the association between PNI and time to first MACE.
RESULTS: During a median follow - up period of 38.5 months, 176 MACE events occurred (32.2%). Multivariate Cox regression analysis showed that after adjusting for all confounding factors, each one - unit increase in PNI was associated with a 2.9% reduction in MACE risk (HR 0.971, 95% CI 0.947-0.997, P = 0.026). Compared with the T1 group, the T3 group had a 34.5% lower risk of MACE (HR 0.655, 95% CI 0.447-0.960, P = 0.030). Multiple subgroup and sensitivity analyses further confirmed the robustness of the results. Time - dependent ROC analysis indicated that PNI had modest predictive value for MACE risk (overall population: time=dependent AUC at 12, 24, and 36 months were 0.588, 0.575, and 0.562). Kaplan - Meier survival curves demonstrated significant differences in cumulative MACE risk among PNI tertiles, with the T1 group having the poorest prognosis (Log - rank P = 0.010).
CONCLUSION: Lower PNI levels are independently associated with an increased risk of MACE in TV - CHD patients. Given its modest discriminatory ability, PNI should be considered a readily available, cost - effective supplementary biomarker that may provide adjunctive prognostic value in the comprehensive assessment of this high - risk population.
PMID:42028556 | PMC:PMC13101814 | DOI:10.2147/IJGM.S603394