Prognostic Nutrition Index May Predict Cerebral Embolic Events Following Carotid Artery Stenting Procedure

Authors : Ahmet GÜNER, Ömer ÇELİK, Ahmet Arif YALÇIN, Murat ÖRTEN, Serkan KAHRAMAN, Macit KALÇIK, Ezgi GÜLTEKİN GÜNER, Çağdaş TOPEL, Mehmet ERTÜRK

Pages : 40-49

View : 27 | Download : 10

Publication Date : 2022-04-18

Article Type : Research Paper

Abstract :Introduction: Cerebral embolism after carotid artery stenting insert ignore into journalissuearticles values(CAS); remains a matter of concern in frailty patients. The prognostic nutrition index insert ignore into journalissuearticles values(PNI);, which provides an objective assessment of nutritional status, is a useful prognostic indicator in cardiovascular diseases. We aim to determine the value of pre-procedural PNI in predicting cerebral embolism including stroke, transient ischemic attack insert ignore into journalissuearticles values(TIA);, and silent new ischemic cerebral lesions insert ignore into journalissuearticles values(SNICLs);. Patients and Methods: We retrospectively evaluated 138 patients insert ignore into journalissuearticles values(mean age= 70.6 ± 6.7 years, male= 99); who underwent CAS. Inclusion criteria were as follows: i); availability of all medical records including albumin value and lymphocyte count, ii); having cranial imaging after CAS, iii); having symptomatic carotid stenosis 50-99% or asymptomatic carotid stenosis ≥60-99%. The study population was divided into two subgroups according to the presence of cerebral embolism as cerebral embolism insert ignore into journalissuearticles values(+); cerebral embolism insert ignore into journalissuearticles values(-); groups. Results: Among the study population, 22 patients insert ignore into journalissuearticles values(16%); had at least 1 SNICL, seven patients insert ignore into journalissuearticles values(5.0%); had an ischemic stroke, and five patients insert ignore into journalissuearticles values(3.6%); had TIA. The cerebral embolism insert ignore into journalissuearticles values(+); group had a significantly lower PNI, older age, more frequent history of stroke, a higher proportion of type III aortic arch, and longer fluoroscopy time than the cerebral embolism insert ignore into journalissuearticles values(-); group. Low PNI was identified as one of the independent predictors of cerebral embolism insert ignore into journalissuearticles values(OR= 0.808; 95% CI= 0.670-0.975; p= 0.026);, and PNI lower than 44.7 predicted cerebral embolism with a sensitivity of 70.6% and a specificity of 61.1% insert ignore into journalissuearticles values(AUC= 0.739; 95% CI= 0.651 to 0.827; p< 0.001);. Conclusion: The current data suggest that PNI is an independent prognostic factor for cerebral embolic complications after CAS procedures.
Keywords : Stroke, magnetic resonance imaging, carotid artery, stent endovascular