Impact of geriatric nutritional risk index on clinical outcomes in acute coronary syndrome patients: a comprehensive meta-analysis.

Background: The Geriatric Nutritional Risk Index (GNRI), derived from serum albumin levels and body weight relative to ideal body weight, is a novel tool for assessing nutritional status. This meta-analysis explored the association between GNRI and the clinical outcomes in patients with acute coronary syndrome (ACS).

Methods: We systematically searched PubMed, Embase, and Web of Science for studies evaluating the GNRI in patients with ACS. Inclusion criteria were observational studies reporting all-cause mortality or major adverse cardiovascular events (MACEs) among ACS patients categorized by low versus normal GNRI. Data extraction and quality assessment were independently performed by two authors, utilizing a random-effects model to account for potential heterogeneity.

Results: Eleven cohort studies, encompassing 18 616 patients with ACS, were included. A low GNRI was associated with significantly increased risks of all-cause mortality (RR, 1.95; 95% CI, 1.63-2.34; P < 0.001; I² = 32%) and MACEs (RR, 1.93; 95% CI, 1.62-2.29; P < 0.001; I² = 25%). Subgroup analyses for the all-cause mortality outcome showed consistent findings across varied study designs, patient demographics, and follow-up periods (P for subgroup differences all >0.05). Sensitivity analyses conducted by sequentially excluding individual studies confirmed the stability of these results.

Conclusion: A low GNRI at the time of admission is a significant predictor of increased all-cause mortality and MACEs in patients with ACS.