AUTHOR=Wang Di , Jia Congkang , Yu Tao TITLE=Association between prognostic nutritional index and the clinical outcomes of patients with acute myocardial infarction: a systematic review and meta-analysis JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1650043 DOI=10.3389/fcvm.2025.1650043 ISSN=2297-055X ABSTRACT=BackgroundEmerging data suggest a correlation between the prognostic nutritional index (PNI) and the clinical outcomes of patients with acute myocardial infarction. Despite these findings, the overall conclusions remain inconclusive.MethodsA comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library, covering the period to October 31, 2024, Examining the relationship between PNI and clinical outcomes in AMI patients. The outcomes included mortality due to acute myocardial infarction, major adverse cardiovascular events (MACE), in-hospital mortality, and acute kidney injury. These outcomes were using hazard ratios (HR) and corresponding 95% confidence intervals (CI). Sensitivity and subgroup analysis were used to assess the stability of the results and potential sources of heterogeneity. All analyses were performed using Review Manager 5.4 and STATA 15.0.ResultsOur analysis included twelve retrospective cohort studies and two prospective studies. Demonstrated a correlation between PNI values and mortality (HR = 0.91, 95% CI: 0.91–0.85; p < 0.0001). No significant association between the PNI and the incidence of MACE in patients with AMI (HR = 0.85, 95% CI: 0.66–1.11; p = 0.23). Sensitivity and subgroup analysis confirmed the stability of the results.ConclusionPNI has a strong link to lower mortality rates in patients with AMI, higher the PNI values correspond to lower mortality risk. No significant relationship between PNI and MACE was observed. PNI could be an important factor in individualized managenent of AMI patients in clinical settings.Systematic Review RegistrationPROSPERO, identifier CRD42024620983.