Akademik Veri Yönetim Sistemi
Health sciences quarterly (Online), cilt.6, sa.1, ss.221-233, 2026 (TRDizin)
To evaluate the prognostic value of the Nutritional Inflammatory Score (NIS) and neutrophil-to-lymphocyte ratio (NLR) in predicting long-term major adverse cardiovascular events (MACE) and all-cause mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI). This retrospective cohort study included 314 patients with NSTEMI who were admitted between 2013 and 2016. Baseline NIS (calculated as albumin/NLR) and NLR values were obtained from admission laboratory data. The primary outcome was MACE, defined as a composite of cardiovascular death, recurrent myocardial infarction, heart failure hospitalization, and repeat revascularization. The secondary outcome was all-cause mortality. Patients were followed for a mean of 99.7 ± 22.0 months. Cox regression analysis, receiver operating characteristic (ROC) curves, and Kaplan-Meier survival estimates were used to assess prognostic significance. Multivariate Cox regression showed that NIS was an independent predictor of both MACE (HR: 0.719, 95% CI: 0.631–0.819, p<0.001) and all-cause mortality (HR: 0.885, 95% CI: 0.788–0.994, p=0.040). NLR was predictive of MACE but not mortality. NIS demonstrated superior predictive performance (AUC: 0.886 for MACE; 0.799 for mortality). Kaplan-Meier analysis showed significantly higher event and mortality rates in patients with lower NIS values. NIS, a simple and readily accessible marker that integrates inflammatory and nutritional status, is a strong independent predictor of long-term outcomes in NSTEMI patients. It outperforms NLR and may enhance clinical risk stratification and personalized patient management.