Value of advanced lung cancer inflammation index in predicting the prognosis of patients with atrial fibrillation and heart failure

Abstract:

Objective To investigate the value of advanced lung cancer inflammation index（ALI） in predicting the all-cause mortality of patients with atrial fibrillation（AF） and heart failure（HF）.Methods Related clinical data were collected from the patients with AF and HF in The First Affiliated Hospital of Chongqing Medical University，and the receiver operating characteristic（ROC） curve was used to assess the value of ALI in predicting all-cause mortality. Youden index was used to determine the cut-off value of ALI，and the patients were divided into ALI>16.99 group and ALI≤16.99 group according to the ALI value on admission. The Kaplan-Meier curve was used to analyze survival time，and finally the multivariate Cox stepwise regression analysis was used to investigate the influence of ALI on the all-cause mortality of this population. The samples were divided into valvular and non-valvular AF for subgroup analysis.Results A total of 614 patients with AF and HF were enrolled，among whom 49 patients were lost to follow-up，and a statistical analysis was performed for the remaining 565 patients，with 370 patients in the ALI>16.99 group and 195 patients in the ALI≤16.99 group. There were 113 cases（57.9%） of all-cause mortality in the ALI≤16.99 group and 104 cases（28.1%） of all-cause mortality in the ALI>16.99 group. Compared with the ALI>16.99 group，the ALI≤16.99 group had significantly higher age，brain natriuretic peptide，D-dimer，percentage of neutrophils，blood urea nitrogen，creatinine，high-sensitivity C-reactive protein，activated partial thromboplastin time，white blood cell count，NYHA class，and HAS-BLED score，as well as significantly lower body mass index，hemoglobin，lymphocyte count，albumin，total cholesterol，low-density lipoprotein，and high-density lipoprotein（all P<0.05）. ALI had an area under the ROC curve of 0.660（95%CI=0.614-0.705，P<0.001） in predicting all-cause mortality of patients with AF and HF. The multivariate Cox regression analysis showed that ALI≤16.99，creatinine，age>65 years，and primary hypertension were independent risk factors for all-cause mortality of patients with AF and HF，and the subgroup analysis showed that ALI≤16.99 was an independent risk factor for all-cause mortality in patients with valvular or non-valvular AF-HF.Conclusion ALI is associated with all-cause mortality in patients with AF-HF，and ALI≤16.99 is an independent risk factor for all-cause mortality in such patients. Therefore，ALI may help to assess the prognosis of patients with AF-HF.