Prognostic value of Glasgow Prognostic Score and its modified scores on 5-year outcome in patients with coronary heart disease undergoing percutaneous coronary intervention.

ABSTRACT

Background: Glasgow Prognostic Score (GPS) and its modified counterparts, including the modified GPS (mGPS) and hsCRP-modified GPS (hs-mGPS), are widely used inflammatory indices in clinical settings. Inflammation has gained increased attention in the context of coronary heart disease (CHD); however, its long-term predictive value in patients with CHD remains uncertain. Objective: This study aimed to assess the predictive values of GPS, mGPS, and hs-mGPS for long-term survival in patients following percutaneous coronary intervention (PCI). Methods: Consecutive 10,724 PCI patients were enrolled in 2013. The primary endpoint was 5-year all-cause death. Results: This study included 8,909 patients. Individuals with high GPS, mGPS, and hs-mGPS scores exhibited a significantly higher risk of all-cause death compared to those with low scores (all P < 0.05). All three indices (GPS, mGPS, and hs-mGPS) demonstrated predictive values for all-cause death, albeit with relatively low area under the curve values of 0.534, 0.522, and 0.545, respectively. Furthermore, we refined the hs-mGPS using cutoffs (hsCRP at 2 mg/L and albumin at 40 g/L) which are better suited for these patients, to establish the CHD-hs-mGPS. This modification significantly improved the prediction of all-cause death, outperformed the mGPS and demonstrated numerical superiority over both the GPS and hs-mGPS. Notably, only CHD-hs-mGPS exhibited a predictive value for both the ACS and non-ACS subgroups. Conclusion: In patients with CHD who underwent PCI, GPS, mGPS, and hs-mGPS demonstrated significant long-term predictive values for all-cause death. Our parameter-adjusted score, the CHD-hs-mGPS, is applicable to a broad population and moderately enhances the predictive accuracy, facilitating the early identification of patients at high risk of long-term death.