Nutritional-inflammatory balance assessed by advanced lung cancer inflammation index and its association with all-cause mortality in coronary heart disease : a retrospective cohort study

The present study aimed to evaluate the association between advanced lung cancer inflammation index (ALI) and all-cause mortality in a population of patients with Coronary Heart Disease(CHD) using a retrospective cohort study design. Data were obtained from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). ALI was calculated as BMI × albumin level ÷ NLR, integrating anthropometric, nutritional, and inflammatory biomarkers. History of CHD was obtained using a questionnaire. We used Cox regression analysis to explore potential relationships and examined the nonlinear relationship using Restricted Cubic Splines (RCS). A total of 1,295 participants were included in the study. Cox regression results revealed that a higher ALI was associated with lower all-cause mortality in patients with CHD. The subgroup and interaction analyses showed that the results were consistent. After adjusting for all covariates, participants in quartile 4 of ALI showed a 39% reduction in all-cause mortality compared to quartile 1. RCS analysis indicates a U-shaped relationship with a breaking point of 117.33. In the United States, higher ALI was associated with lower all-cause mortality among patients with CHD. These findings suggest a potential association between ALI and all-cause mortality in CHD patients that warrants further investigation in prospective studies. Future interventional studies are needed to determine whether strategies targeting the components of ALI could improve clinical outcomes in this population.