Background: Although clinical frailty and nutritional status are associated with adverse events in patients after percutaneous coronary intervention (PCI), those two factors are closely interrelated. This study evaluated the prognostic utility of the Geriatric Nutritional Risk Index (GNRI), a nutritional risk assessment tool, in stratifying outcomes in patients with and without frailty.

Methods: We used data from a prospective multicenter registry (SAKURA PCI2 Antithrombotic Registry) from June 2020 until September 2022. This study included 973 patients who underwent PCI [age: 72 (61, 79) years] and had available data. The patients were stratified into four groups based on the Clinical Frailty Scale (CFS) scores (CFS ≥4 defined as vulnerable frailty) and GNRI values (GNRI <92 defined as a high nutritional risk).

Results: Of the total patients, 67 (6.9 %) had vulnerable frailty and GNRI <92, 115 (11.8 %) vulnerable frailty and GNRI ≥92, 98 (10.1 %) non-frailty and GNRI <92, and 693 (71.2 %) non-frailty and GNRI ≥92. During a median follow-up of 737 (565-956) days, a Kaplan-Meier curve revealed that patients with a GNRI <92 had higher rates of composite adverse events, including all-cause death, non-fatal myocardial infarctions, stent thromboses, hospitalizations for heart failure, Bleeding Academic Research Consortium 3 or 5 bleeding events, strokes, and venous thromboembolisms, regardless of the frailty status (log-rank, p < 0.05 for both). After adjusting for potential confounding factors, the vulnerable frailty group with a GNRI <92 had the highest composite adverse event rates, with a hazard ratio of 2.51 (95 % confidence interval 1.59-3.95, p < 0.001) compared to the non-frailty group with a GNRI ≥92.

Conclusions: Both frailty and malnutrition were significantly linked to adverse outcomes in post-PCI patients, with malnutrition exerting an influence regardless of the frailty status. The GNRI, in particular, served as a valuable prognostic tool, enhancing the risk stratification among frail patients following PCI.

Keywords: Clinical frailty scale; Frailty; Geriatric nutritional risk index; Malnutrition.

Copyright © 2025. Published by Elsevier Ltd.

背景： 尽管临床虚弱和营养状况与经皮冠状动脉介入治疗（PCI）后患者的不良事件相关，但这两个因素密切相关。本研究评估了老年营养风险指数（GNRI），一种营养风险评估工具，在有无虚弱的患者中分层预后的实用性。

方法： 我们使用了一项前瞻性多中心登记数据（SAKURA PCI2 抗血栓注册）从2020年6月至2022年9月的数据。该研究包括了973名接受PCI治疗的患者[年龄：72 (61, 79) 岁]，并且这些患者有可用数据。根据临床虚弱量表（CFS）评分（CFS ≥4 定义为脆弱性虚弱）和GNRI值（GNRI

结果： 在所有患者中，67名 (6.9%) 患有脆弱性虚弱且 GNRI

结论： 临床虚弱和营养不良均显著影响PCI后患者的不良预后，而营养不良的影响不依赖于患者是否处于脆弱状态。特别是GNRI作为一个有价值的预测工具，在PCI术后脆弱性患者的危险分层中表现出增强作用。

关键词： 临床虚弱量表；虚弱；老年营养风险指数；营养不良。