{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:11:12Z","timestamp":1789031472178,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Systemic inflammation and nutritional impairment may influence outcomes after permanent pacemaker implantation, but the prognostic value of composite indices in degenerative complete atrioventricular block remains unclear. We evaluated the associations of routinely available inflammatory and nutritional indices with long-term all-cause mortality in this population. Materials and Methods: This retrospective, single-center study included 272 patients who underwent permanent pacemaker implantation for isolated complete atrioventricular block attributed to degenerative conduction system disease between August 2020 and July 2024. Baseline laboratory values were used to calculate the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and pan-immune-inflammation value. The primary endpoint was all-cause mortality during follow-up. Discriminatory performance was assessed using receiver operating characteristic (ROC) analysis, and independent associations were evaluated using multivariable Cox regression. Results: During a mean follow-up of 27.8 \u00b1 16.6 months, 69 patients (25.4%) died. Compared with survivors, non-survivors were older and had lower hemoglobin, lymphocyte count, albumin, estimated glomerular filtration rate, GNRI, LMR, and PNI values, whereas C-reactive protein, NLR, and SIRI values were higher. PNI had the numerically highest AUC for mortality prediction (AUC: 0.720, 95% CI: 0.648\u20130.793; p &lt; 0.001), corresponding to moderate discriminatory performance, whereas GNRI showed fair discrimination (AUC: 0.677, 95% CI: 0.589\u20130.766; p &lt; 0.001). In multivariable Cox regression, PNI remained independently associated with mortality (HR: 0.945, 95% CI: 0.909\u20130.982; p = 0.004). Conclusions: Among the evaluated inflammatory and nutritional indices, PNI demonstrated the numerically highest discriminatory performance and remained independently associated with long-term all-cause mortality. PNI may therefore serve as a readily available adjunct to clinical risk stratification in patients undergoing permanent pacemaker implantation for degenerative complete atrioventricular block; however, external validation is required.<\/jats:p>","DOI":"10.3390\/medicina62091741","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:07:41Z","timestamp":1789027661000},"page":"1741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Inflammatory and Nutritional Indices in Patients Undergoing Permanent Pacemaker Implantation for Degenerative Complete Atrioventricular Block"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4721-5899","authenticated-orcid":false,"given":"Murat Erdem","family":"Alp","sequence":"first","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7504-3582","authenticated-orcid":false,"given":"Cemal","family":"Ozanalp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6891-9457","authenticated-orcid":false,"given":"G\u00fcng\u00f6r \u0130layda","family":"Bostanc\u0131 Alp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Kertmen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0792-628X","authenticated-orcid":false,"given":"Ey\u00fcp","family":"\u00d6zkan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3871-8248","authenticated-orcid":false,"given":"Veli","family":"Polat","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2666-4983","authenticated-orcid":false,"given":"S\u00fcleyman","family":"Barut\u00e7u","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Taylan","family":"Akg\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Istanbul Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital, Istanbul 34480, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur. 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