Prognostic utility of advanced lung cancer inflammation index in heart failure with preserved ejection fraction

IF 3.7 2区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
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
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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.

Abstract Image

晚期肺癌炎症指数在保留射血分数的心力衰竭中的预后价值。
目的:营养不良和炎症与心力衰竭(HF)预后不良相关。晚期肺癌炎症指数(ALI)是一种综合炎症和营养状况的指标,由体重指数×血清白蛋白水平/中性粒细胞与淋巴细胞比值计算得出,已被发展为包括心衰在内的几种疾病的预后指标。本研究的目的是探讨ALI对保留射血分数(HFpEF)的老年多病HF患者的预后价值。方法:该研究使用了来自保射血分数心衰患者的前瞻性多中心观察性研究(PURSUIT-HFpEF)的数据。纳入急性失代偿性心衰患者,左室射血分数≥50%。ALI水平根据出院数据计算。主要终点是全因死亡。结果:共纳入1238例患者[83(77,87)岁,555例(45%)男性],其中1121例分析了ALI的预后价值。在多变量Cox模型中,ALI与主要终点显著相关[对数转换ALI的校正风险比(HR): 0.50, 95%可信区间(CI): 0.34-0.75, P = 0.001]。ALI似乎增强了MAGGIC风险评分的预后价值[净再分类改善(NRI) = 46% (95% CI: 28%-65%), P]结论:低ALI水平与老年多病HFpEF患者预后不良显著相关。ALI可以补充现有的预后评估风险指标。
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来源期刊
ESC Heart Failure
ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
7.00
自引率
7.90%
发文量
461
审稿时长
12 weeks
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.
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