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The Prognostic Value of the Advanced Lung Cancer Inflammation Index for Major Cardiovascular and Cerebrovascular
Mehmet Karaca1, Muhsin Kalyoncuoğlu2, Ahmet Zengin3
1Cardiology Department, Atasehir Memorial Hospital, Uskudar University, Istanbul 34662, Turkey.
Insights
The advanced lung cancer inflammation index (ALI) can predict major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST elevation myocardial infarction (NSTEMI) patients. Lower ALI values indicate a higher risk of MACCEs after percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI) face risks of major adverse cardiovascular and cerebrovascular events (MACCEs).
- Inflammation plays a crucial role in cardiovascular disease progression.
- Novel biomarkers are needed for accurate risk stratification in NSTEMI patients.
Purpose of the Study:
- To investigate the prognostic value of the admission advanced lung cancer inflammation index (ALI) for one-year MACCEs in NSTEMI patients undergoing PCI.
- To compare the predictive accuracy of ALI with other inflammation-based biomarkers.
Main Methods:
- A cohort of 1173 NSTEMI patients undergoing PCI was studied.
- ALI was calculated using body mass index (BMI), serum albumin, and neutrophil-to-lymphocyte ratio (NLR).
- ROC analysis was used to compare the discriminatory power of ALI against NLR, CAR, and UAR for predicting one-year MACCEs.
Main Results:
- 13.5% of patients experienced MACCEs within one year.
- Lower admission ALI values were significantly associated with increased MACCEs (p < 0.001).
- ALI demonstrated superior predictive accuracy for MACCEs compared to albumin, NLR, CAR, and UAR (AUC = 0.658).
Conclusions:
- Admission ALI is a valuable prognostic biomarker for predicting one-year MACCEs in NSTEMI patients undergoing PCI.
- An ALI value below 43.9 identifies patients at higher risk.
- Incorporating ALI into risk assessment may enhance prognostication and guide clinical management.
Abstract:
Objectives: Our aim was to investigate whether admission advanced lung cancer inflammation index (ALI) values have a prognostic role on one-year major adverse cardiovascular and cerebrovascular events (MACCEs) in non-ST elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). Methods: Our study consisted of 1173 consecutive patients aged 61.9 ± 12.5 years. The study population was divided into two groups according to the occurrence of MACCEs. BMI (body mass index), serum albumin levels and NLR (neutrophil to lymphocyte ratio) of patients were collected from hospital records, and ALI was calculated based on the following formula: BMI × serum albumin/NLR. We also calculated neutrophil to lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR) and uric acid to albumin ratio (UAR) and investigated the association of these inflammation-based biomarkers with one-year MACCEs. Results: During the 12-month follow-up period, 158 (13.5%) patients had MACCEs, 55 (4.7%) of whom had all-cause mortality, 96 (8.2%) had nonfatal MI and 7 (0.6%) had nonfatal stroke. Patients with MACCEs had significantly lower ALI (p < 0.001), and also ALI (area under the curve [AUC] = 0.658, p < 0.001) had better discriminatory power and predictive accuracy in determining one-year MACCEs compared to albumin (AUC = 0.594, p < 0.001), NLR (AUC = 0.631, p < 0.001), CAR (AUC = 0.595, p < 0.001) and UAR (AUC = 0.577, p = 0.001) in the ROC analysis. Individuals with an ALI value lower than 43.9 were at greater risk of developing MACCEs (p < 0.001) due to the Delong test. Conclusions: Determining the level of ALI may have the potential to improve risk prognostication in NSTEMI patients undergoing revascularization therapy.
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