Geriatric nutritional risk Index predicts adverse outcomes across cardiovascular–kidney–metabolic syndrome: discovery in NHANES and external validation in CKM stage 4 patients undergoing PCI - Report - MDSpire

Geriatric nutritional risk Index predicts adverse outcomes across cardiovascular–kidney–metabolic syndrome: discovery in NHANES and external validation in CKM stage 4 patients undergoing PCI

  • By

  • Hongyan Zhu

  • Jing Yang

  • Yuqi Fang

  • Yizhu Yan

  • July 7, 2026

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Geriatric Nutritional Risk Index as a Predictor of Negative Outcomes in CKM Syndrome

Overview

The Geriatric Nutritional Risk Index (GNRI) is associated with adverse outcomes in patients with cardiovascular–kidney–metabolic (CKM) syndrome. Lower GNRI scores correlate with higher risks of all-cause mortality and major adverse cardiovascular events (MACE) in both discovery and validation cohorts.

Background

CKM syndrome is a significant health concern due to its association with increased morbidity and mortality. Identifying reliable prognostic biomarkers is crucial for early intervention and risk stratification in affected patients.

Data Highlights

CohortGNRI QuartileHazard Ratio (HR)95% Confidence Interval (CI)
DiscoveryQ1 vs. Q41.58 (all-cause mortality)1.32–1.89
DiscoveryQ1 vs. Q42.13 (cardiovascular mortality)1.55–2.93
ValidationQ1 vs. Q42.52 (MACE)2.03–3.13
Both CohortsEach 1-unit increase in GNRI0.95 (all-cause mortality)0.94–0.97
Both CohortsEach 1-unit increase in GNRI0.95 (MACE)0.94–0.96

Key Findings

  • Lower GNRI scores are linked to higher hazards of all-cause and cardiovascular mortality.
  • In CKM Stage 4 patients undergoing PCI, lower GNRI significantly increases the risk of MACE.
  • Each 1-unit increase in GNRI correlates with a lower hazard of adverse outcomes.
  • GNRI shows a non-linear inverse relationship with risk, particularly below a score of 100.
  • Incorporating GNRI into clinical models enhances risk discrimination for MACE.

Clinical Implications

The GNRI can be utilized as a tool for identifying high-risk patients within the CKM syndrome spectrum.

Conclusion

The GNRI serves as an independent predictor of adverse outcomes in CKM syndrome.

Related Resources & Content

  1. American College of Cardiology, 2026 -- First-ever guideline on cardiovascular-kidney-metabolic syndrome issued
  2. Frontiers in Cardiovascular Medicine, 2026 -- Prognostic value of prognostic nutritional index in patients with heart failure: a systematic review and meta-analysis
  3. Frontiers in Medicine, 2026 -- Prognostic value of the aggregate index of systemic inflammation and controlling nutritional status score for all-cause mortality in patients undergoing maintenance hemodialysis: a retrospective cohort study
  4. Frontiers in Medicine, 2026 -- Development of a Nomogram for Predicting Incident Heart Failure and All-cause Mortality in Patients with Chronic Kidney Disease: A 3-year Follow-up Study
  5. European Journal of Preventive Cardiology, 2026 -- Cardiovascular risk prediction in older persons: ready for primetime
  6. First-ever guideline on cardiovascular-kidney-metabolic syndrome issued - American College of Cardiology
  7. https://www.pjms.org.pk/index.php/pjms/article/download/12092/2929/75911

Original Source(s)

Geriatric nutritional risk Index predicts adverse outcomes across cardiovascular–kidney–metabolic syndrome: discovery in NHANES and external validation in CKM stage 4 patients undergoing PCI

  • by Hongyan Zhu, Jing Yang, Yuqi Fang, Yizhu Yan

  • July 7, 2026

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