The prognostic value of advanced lung cancer inflammation index (ALI) in elderly patients with heart failure

作者全名："Yuan, Xiao; Huang, Bi; Wang, Ruiyu; Tie, Hongtao; Luo, Suxin"

作者地址："[Yuan, Xiao; Huang, Bi; Luo, Suxin] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China; [Wang, Ruiyu] Chongqing Med Univ, Inst Life Sci, Chongqing, Peoples R China; [Tie, Hongtao] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China"

通信作者："Luo, SX (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China."

来源：FRONTIERS IN CARDIOVASCULAR MEDICINE

ESI学科分类：　

WOS号：WOS:000890512100001

JCR分区：Q2

影响因子：3.6

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：heart failure; elderly; nutrition; inflammation; advanced lung cancer inflammation index; mortality

摘要："PurposeThe advanced lung cancer inflammation index (ALI) is a novel inflammatory and nutritional index that exerts prognostic value in various types of cancer. A previous study demonstrated that ALI at discharge could predict the prognosis in patients with acute decompensated heart failure (ADHF). However, the long-term prognostic value of ALI on admission in elderly heart failure (HF) inpatients remains unclear. Materials and methodsWe retrospectively collected HF inpatients over 65-year-old who were hospitalized in our cardiology center during the whole year of 2015. ALI was calculated as body mass index (BMI) x serum albumin (Alb)/neutrophil-to-lymphocyte ratio (NLR). Patients were divided into two groups by the optimal cutoff value of ALI for predicting all-cause mortality using time-dependent receiver operating characteristic (ROC) curves. The Spearman rank correlation coefficient was computed to evaluate the correlation between ALI and the geriatric nutritional risk index (GNRI). Kaplan-Meier curves, Cox survival analyses, time-dependent ROC analyses, and net reclassification improvement (NRI) analyses were used to assess the prognostic effect of ALI on all-cause mortality and cardiovascular mortality. ResultsOver a 28-month median follow-up, all-cause and cardiovascular mortality occurred in 192 (35.4%) and 132 (24.3%) out of 543 patients, respectively. The optimal cutoff value of ALI for predicting all-cause mortality at 2 years was 25.8. Spearman's correlation coefficient showed a moderate positive linear correlation between ALI and GNRI (r = 0.44, p < 0.001). The Kaplan-Meier analysis revealed that the cumulative incidences of both all-cause and cardiovascular mortalities were significantly higher in patients with lower ALI (log-rank test, all-cause mortality: p < 0.0001; cardiovascular mortality: p < 0.0001). The multivariate Cox proportional hazard analyses indicated that ALI was an independent predictor for both all-cause mortality (HR 0.550, 95% CI 0.349-0.867, p = 0.01) and cardiovascular mortality (HR 0.536, 95% CI 0.302-0.953, p = 0.034). Time-dependent ROC analyses showed that ALI was comparable to GNRI in predicting long-term all-cause mortality (AUC: ALI 0.625, GNRI 0.641, p = 0.976) and cardiovascular mortality (AUC: ALI 0.632, GNRI 0.626, p = 0.999) at 2 years. However, the estimated NRI indicated that the addition of ALI could not significantly improve risk stratification of base models for all-cause mortality (categorical NRI 4.9%, p = 0.433, continuous NRI 25%, p = 0.022) or cardiovascular mortality (categorical NRI 6.5%, p = 0.223, continuous NRI 27.5%, p = 0.029). ConclusionHigher ALI was significantly associated with lower all-cause and cardiovascular mortalities in elderly HF patients. ALI on admission could be a competent nutrition-inflammation marker with independent predictive value for evaluating the long-term mortality of HF in elder population."

基金机构：First Affiliated Hospital of Chongqing Medical University Discipline Improvement Projects [2020jstg023]; Chongqing Healthy Committee; Chongqing Talent plan; [XKTS125]

基金资助正文："This study was supported by The First Affiliated Hospital of Chongqing Medical University Discipline Improvement Projects (XKTS125), Chongqing Healthy Committee (2020jstg023), and 2021 Project of Chongqing Talent plan."