Predictive Value of the Global Immune–Nutrition–Inflammation Index for Myocardial Infarction Risk in Patients with Unstable Angina and Type 2 Diabetes Mellitus

Abstract

Background: Patients with unstable angina (UA) and type 2 diabetes mellitus (T2DM) face a high risk of myocardial infarction (MI) driven by systemic inflammation, immune dyshomeostasis, and metabolic derangements. This study evaluated the prognostic value of the global immune-nutrition-inflammation (GINI) index for predicting MI in this high-risk cohort. Methods: This retrospective, single-center observational study included 212 patients with unstable angina (UA) and type 2 diabetes mellitus (T2DM), stratified into MI (n=58) and non-MI (n=154) groups based on clinical progression. Biochemical assays were conducted to determine serum albumin, C-reactive protein, glycated hemoglobin, and serum lipid parameters. Hematological indices, including absolute neutrophil, lymphocyte, monocyte, and platelet counts, were also quantified. Baseline GINI, systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and prognostic nutritional index (PNI) were calculated. Predictive performance was assessed using multivariate logistic regression, receiver operating characteristic (ROC) curve analysis, and tertile-based risk stratification. Results: GINI was significantly elevated in the MI group compared to the non-MI group (1245.7 ± 315.6 vs 820.5 ± 210.3, P<0.001) and correlated positively with hs-CRP, fasting glucose, and HbA1c (all P