{"title":"Prognostic utility of advanced lung cancer inflammation index in heart failure with preserved ejection fraction","authors":"Daisuke Sakamoto, Yuki Matsuoka, Masahiro Seo, Takahisa Yamada, Daisaku Nakatani, Katsuki Okada, Akihiro Sunaga, Hirota Kida, Taiki Sato, Tetsuhisa Kitamura, Shunsuke Tamaki, Masamichi Yano, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Yoshio Yasumura, Shungo Hikoso, Yohei Sotomi, Yasushi Sakata, the OCVC-Heart Failure Investigators","doi":"10.1002/ehf2.15313","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>Malnutrition and inflammation are associated with poor outcomes with heart failure (HF). As a marker integrating inflammation and nutritional status, the advanced lung cancer inflammation index (ALI), calculated by body mass index × serum albumin level / neutrophil-to-lymphocyte ratio, has been developed for the prognosis of several diseases including HF. The aim of this study is to investigate the prognostic value of ALI in elderly multimorbid HF patients with HF with preserved ejection fraction (HFpEF).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The study utilized data from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction (PURSUIT-HFpEF). Patients with acute decompensated HF and left ventricular ejection fraction ≥50% were included. ALI levels were calculated from discharge data. The primary endpoint was all-cause death.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1238 patients [83 (77, 87) years, 555 (45%) male] were enrolled, with 1121 analysed for prognostic value of ALI. In the multivariable Cox model, ALI was significantly associated with the primary endpoint [adjusted hazard ratio (HR) for log-transformed ALI: 0.50, 95% confidence interval (CI): 0.34–0.75, <i>P</i> = 0.001]. ALI appears to enhance the prognostic value of the MAGGIC risk score [net reclassification improvement (NRI) = 46% (95% CI: 28%–65%), <i>P</i> < 0.001; integrated discrimination improvement (IDI) = 4.6% (95% CI: 2.8%–6.5%), <i>P</i> < 0.001], the geriatric nutritional risk index [NRI = 16% (95% CI: −3% to 35%), <i>P</i> = 0.103; IDI = 2.0% (95% CI: 0.8%–3.1%), <i>P</i> < 0.001] and C-reactive protein [NRI = 39% (95% CI: 20%–58%), <i>P</i> < 0.001; IDI = 4.8% (95% CI: 2.9%–6.6%), <i>P</i> < 0.001].</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Low ALI levels were significantly associated with poor prognosis in elderly multimorbid HFpEF patients. ALI might complement existing risk indices for prognostic assessment.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 5","pages":"3361-3371"},"PeriodicalIF":3.7000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15313","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESC Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15313","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims
Malnutrition and inflammation are associated with poor outcomes with heart failure (HF). As a marker integrating inflammation and nutritional status, the advanced lung cancer inflammation index (ALI), calculated by body mass index × serum albumin level / neutrophil-to-lymphocyte ratio, has been developed for the prognosis of several diseases including HF. The aim of this study is to investigate the prognostic value of ALI in elderly multimorbid HF patients with HF with preserved ejection fraction (HFpEF).
Methods
The study utilized data from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction (PURSUIT-HFpEF). Patients with acute decompensated HF and left ventricular ejection fraction ≥50% were included. ALI levels were calculated from discharge data. The primary endpoint was all-cause death.
Results
A total of 1238 patients [83 (77, 87) years, 555 (45%) male] were enrolled, with 1121 analysed for prognostic value of ALI. In the multivariable Cox model, ALI was significantly associated with the primary endpoint [adjusted hazard ratio (HR) for log-transformed ALI: 0.50, 95% confidence interval (CI): 0.34–0.75, P = 0.001]. ALI appears to enhance the prognostic value of the MAGGIC risk score [net reclassification improvement (NRI) = 46% (95% CI: 28%–65%), P < 0.001; integrated discrimination improvement (IDI) = 4.6% (95% CI: 2.8%–6.5%), P < 0.001], the geriatric nutritional risk index [NRI = 16% (95% CI: −3% to 35%), P = 0.103; IDI = 2.0% (95% CI: 0.8%–3.1%), P < 0.001] and C-reactive protein [NRI = 39% (95% CI: 20%–58%), P < 0.001; IDI = 4.8% (95% CI: 2.9%–6.6%), P < 0.001].
Conclusions
Low ALI levels were significantly associated with poor prognosis in elderly multimorbid HFpEF patients. ALI might complement existing risk indices for prognostic assessment.
期刊介绍:
ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.