Higher prognostic nutritional index values were significantly associated with a lower risk of mortality in patients with acute myocardial infarction (HR 0.91).
Meta-Analysis (n=42,146)
Does higher prognostic nutritional index (PNI) predict lower mortality and MACE in patients with acute myocardial infarction?
Higher prognostic nutritional index (PNI) is significantly associated with lower mortality risk in patients with acute myocardial infarction, suggesting its utility as a prognostic tool for individualized management.
Hazard Ratio: 0.91 (95% CI 0.87–0.95)
p-value: p=<0.0001
Background Emerging data suggest a correlation between the prognostic nutritional index (PNI) and the clinical outcomes of patients with acute myocardial infarction. Despite these findings, the overall conclusions remain inconclusive. Methods A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, covering the period to October 31, 2024, Examining the relationship between PNI and clinical outcomes in AMI patients. The outcomes included mortality due to acute myocardial infarction, major adverse cardiovascular events (MACE), in-hospital mortality, and acute kidney injury. These outcomes were using hazard ratios (HR) and corresponding 95% confidence intervals (CI). Sensitivity and subgroup analysis were used to assess the stability of the results and potential sources of heterogeneity. All analyses were performed using Review Manager 5.4 and STATA 15.0. Results Our analysis included twelve retrospective cohort studies and two prospective studies. Demonstrated a correlation between PNI values and mortality (HR = 0.91, 95% CI: 0.91–0.85; p < 0.0001). No significant association between the PNI and the incidence of MACE in patients with AMI (HR = 0.85, 95% CI: 0.66–1.11; p = 0.23). Sensitivity and subgroup analysis confirmed the stability of the results. Conclusion PNI has a strong link to lower mortality rates in patients with AMI, higher the PNI values correspond to lower mortality risk. No significant relationship between PNI and MACE was observed. PNI could be an important factor in individualized managenent of AMI patients in clinical settings. Systematic Review Registration PROSPERO, identifier CRD42024620983.
Wang et al. (2025) conducted a meta-analysis in Acute myocardial infarction (n=42,146). Prognostic nutritional index vs. Lower prognostic nutritional index was evaluated on Mortality (HR 0.91, 95% CI 0.87-0.95, p=<0.0001). Higher prognostic nutritional index values were significantly associated with a lower risk of mortality in patients with acute myocardial infarction (HR 0.91).