Key result
Combined low ALI and GNRI linked to ~211% higher mortality in chronic HF.
Why the study?
This study was undertaken to explore the predictive value of the advanced lung cancer inflammation index combined with the geriatric nutritional risk index for all-cause mortality in patients with chronic heart failure.
Does the combination of advanced lung cancer inflammation index (ALI) and geriatric nutritional risk index (GNRI) predict all-cause mortality in patients with chronic heart failure?
Observational (n=1,123)
No
Does the combination of advanced lung cancer inflammation index (ALI) and geriatric nutritional risk index (GNRI) predict all-cause mortality in patients with chronic heart failure?
Hazard Ratio: 3.113 (95% CI 2.468–3.926)
Absolute Event Rate: 43% vs 20%
p-value: p=<0.001
The combination of low ALI and low GNRI identifies chronic heart failure patients at the highest risk for all-cause mortality, highlighting the prognostic importance of inflammation and nutritional status.
May aid mortality risk stratification in HF inpatients; leaves open need for prospective validation before clinical adoption.
Background This study was undertaken to explore the predictive value of the advanced lung cancer inflammation index (ALI) combined with the geriatric nutritional risk index (GNRI) for all‐cause mortality in patients with CHF. Methods and Results We enrolled 1123 patients with HF admitted to our cardiology department from January 2017 to October 2021. Patients were divided into Group 1 (ALI<24.60 and GNRI<94.41), Group 2 (ALI<24.60 and GNRI≥94.41), Group 3 (ALI≥24.60 and GNRI<94.41) and Group 4 (ALI≥24.60 and GNRI≥94.41), according to the median ALI and GNRI. From the analysis of the relationship between the ALI and GNRI, we concluded that there was a mild positive linear correlation (r= 0.348, p< 0.001) and no interaction (p=0.140) between the ALI and GNRI. Kaplan‒Meier analysis showed that the cumulative incidence of all‐cause mortality in patients with CHF was highest in Group 1 (log‐rank χ 2 126.244, p<0.001). Multivariate Cox proportional hazards analysis revealed that ALI and GNRI were independent predictors of all‐cause mortality in CHF patients (ALI: HR 0.313, 95% CI 0.228‐0.430, p <0.001; GNRI: HR 0.966, 95% CI 0.953‐0.979, p <0.001). The area under the curve (AUC) for ALI combined with GNRI was 0.711 (p<0.001), according to the time‐dependent ROC curve. Conclusion ALI and GNRI were independent predictors of all‐cause mortality in CHF patients. Patients with CHF had the highest risk of all‐cause mortality when the ALI was <24.60 and the GNRI was <94.41. ALI combined with the GNRI has good predictive value for the prognosis of CHF patients.
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Shi et al. (2023) conducted an observational in Chronic heart failure (n=1,123). Low advanced lung cancer inflammation index (ALI <24.60) and low geriatric nutritional risk index (GNRI <94.41) vs. High ALI (≥24.60) and high GNRI (≥94.41) was evaluated on All-cause mortality (HR 3.113, 95% CI 2.468-3.926, p=<0.001). In patients with chronic heart failure, having both a low ALI (<24.60) and a low GNRI (<94.41) was associated with a significantly higher risk of all-cause mortality (HR 3.113) compared to patients with high levels of both indices.
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