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The Prognostic Significance of the Novel Global Immune-Nutrition-Inflammation Index in Forecasting In-Hospital
Hüseyin Karakurt1, Seda Tükenmez Karakurt1
1Department of Cardiology, M.D. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital, Istanbul, Turkey.
Background:
The global immune-nutrition inflammation index (GINI) is a new indicator that integrates blood biochemistry and complete blood count components, offering a comprehensive assessment of immunity, inflammation, and nutritional status. The in-hospital mortality rates for GINI and post-primary percutaneous coronary intervention (pPCI) in patients with ST-elevation myocardial infarction (STEMI) are still unclear, despite evidence indicating the GINI's prognostic value in different types of cancer.
Aim:
This study examined the link between GINI, measured at admission, and in-hospital death rates in STEMI patients.
Methods:
This retrospective study included 1459 consecutive patients diagnosed with STEMI who underwent pPCI. Following the application of exclusion criteria, the 1090 patients left were split into two groups based on the median GINI value of 192. In-hospital mortality rates during follow-up were recorded from the registry.
Results:
The study's primary outcome, in-hospital mortality, was notably higher in patients with a GINI ≥ 192 compared to those with a GINI < 192 (38 [7%] vs. 7 [1.3%], p < 0.001). Univariate and multivariate Cox proportional hazard analyses revealed that the GINI is independently associated with in-hospital mortality. GINI optimal cut-off value of > 688 predicted in-hospital mortality with 66.7% sensitivity and 86.7% specificity. Univariate logistic regression analysis revealed significant correlations between in-hospital mortality, age, systolic blood pressure (SBP), left ventricular ejection fraction (LVEF), and GINI. Further analysis of these variables using the multivariate logistic regression analysis indicated that age, SBP, LVEF, and GINI (OR: 0.882, 95% CI: 0.849-0.916; p < 0.001) were independent predictors for the development of in-hospital mortality.
Conclusion:
This study's results suggest that GINI could be an important independent predictor of in-hospital mortality among STEMI patients treated with pPCI. Patients with a higher GINI are at increased risk of in-hospital mortality.
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