用于预测接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者预后风险的晚期肺癌炎症指数

Advanced Lung Cancer Inflammation Index for Predicting Prognostic Risk for Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

作者信息

Wang Xinchen, Wei Chen, Fan Wenjun, Sun Lixian, Zhang Ying, Sun Qiyu, Liu Yixiang, Liu Jingyi

机构信息

Department of Cardiology, The Affiliated Hospital of Chengde Medical University, The Chengde Institute of Cardiovascular Diseases, Chengde, Hebei, 067000, People's Republic of China.

Department of Clinical Laboratory, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, 067000, People's Republic of China.

出版信息

J Inflamm Res. 2023 Aug 23;16:3631-3641. doi: 10.2147/JIR.S421021. eCollection 2023.

DOI:10.2147/JIR.S421021

PMID:37641701

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10460579/

Abstract

PURPOSE

The decreased advanced lung cancer inflammation index (ALI), defined as body mass index (BMI) * albumin (Alb)/neutrophil-to-lymphocyte ratio (NLR), is an independent prognostic risk factor for overall survival in gastric, lung, and colorectal cancers. This study aimed to investigate the value of ALI in predicting the risk of major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS).

PATIENTS AND METHODS

A total of 1624 patients with ACS undergoing percutaneous coronary intervention (PCI) were consecutively enrolled between January 2016 and December 2018. Follow-up data were collected at 1, 3, 6, and 12 months and annually thereafter. The primary endpoints were MACEs. All endpoints were defined as all-cause mortality, recurrent angina pectoris, restenosis/intra stent thrombosis, stroke, heart failure, and all-cause bleeding.

RESULTS

The MACEs group and non-MACEs group showed significant differences in patients with age >65 years (28 [50.0%] vs 319 [23.7%]), history of heart failure (16 [28.6%] vs 127 [9.4%]), history of ischemic stroke (14 [25.0%] vs 186 [13.8%]), history of cardiogenic shock (6 [10.71%] vs 16 [1.19%]), left ventricular ejection fraction <40% (8 [14.29%] vs 33 [2.46%]), and ALI <343.96 (44 [78.65%] vs 680 [50.60%]) (all p<0.001). The optimal cut-off value for ALI was 334.96. The area under the curve (AUC) of the 1-, 2-, 3-, and 5-year was 0.560, 0.577, 0.665, and 0.749, respectively. The survival rate was significantly lower in the low ALI group than in the high ALI group (log-rank p<0.001). Low ALI was an independent risk factor for the long-term prognosis of patients with ACS after PCI, univariate HR: 3.671, 95% CI: 1.938-6.953, p<0.001; multivariate HR: 3.009, 95% CI: 1.57-5.769, p=0.001.

CONCLUSION

ALI score less than 334.96 is an independent prognostic risk factor for patients with ACS undergoing PCI and may be a novel marker for clinical practice.

摘要

目的

晚期肺癌炎症指数（ALI）降低，定义为体重指数（BMI）×白蛋白（Alb）/中性粒细胞与淋巴细胞比值（NLR），是胃癌、肺癌和结直肠癌总生存的独立预后风险因素。本研究旨在探讨ALI在预测急性冠状动脉综合征（ACS）患者发生主要不良心血管事件（MACE）风险中的价值。

患者与方法

2016年1月至2018年12月期间，连续纳入1624例接受经皮冠状动脉介入治疗（PCI）的ACS患者。在1、3、6和12个月以及此后每年收集随访数据。主要终点为MACE。所有终点定义为全因死亡、复发性心绞痛、再狭窄/支架内血栓形成、中风、心力衰竭和全因出血。

结果

MACE组和非MACE组在年龄>65岁的患者中存在显著差异（28例[50.0%]对319例[23.7%]）、心力衰竭病史（16例[28.6%]对127例[9.4%]）、缺血性中风病史（14例[25.0%]对186例[13.8%]）、心源性休克病史（6例[10.71%]对16例[1.19%]）、左心室射血分数<40%（8例[14.29%]对33例[2.46%]）以及ALI<343.96（44例[78.65%]对680例[50.60%]）（所有p<0.001）。ALI的最佳截断值为334.96。1年、2年、3年和5年的曲线下面积（AUC）分别为0.560、0.577、0.665和0.749。低ALI组的生存率显著低于高ALI组（对数秩检验p<0.001）。低ALI是PCI术后ACS患者长期预后的独立危险因素，单因素HR：3.671，95%CI：1.938 - 6.953，p<0.001；多因素HR：3.009，95%CI：1.57 - 5.769，p = 0.001。