Key result
Higher mCONUT score linked to ~17% higher odds of in-hospital de novo HF after STEMI.
Why the study?
De novo HF during a first STEMI hospitalization increases mortality and readmission, but the exact association of nutritional and inflammatory indicators such as ALI and the mCONUT score with post-STEMI de novo HF remained unclear.
Do the advanced lung cancer inflammation index (ALI) and modified Controlling Nutritional Status (mCONUT) score predict in-hospital de novo heart failure in patients undergoing PCI for a first STEMI?
Cohort (n=1,598)
No
Do the advanced lung cancer inflammation index (ALI) and modified Controlling Nutritional Status (mCONUT) score predict in-hospital de novo heart failure in patients undergoing PCI for a first STEMI?
In patients undergoing PCI for first-time STEMI, the mCONUT score outperforms the ALI score and provides significant incremental value beyond traditional risk factors for predicting in-hospital de novo heart failure.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for nutritional-inflammatory risk stratification after STEMI, though retrospective design should not yet change practice; leaves open whether targeted interventions improve post-PCI HF outcomes.
BACKGROUND: De novo heart failure (HF) during the first ST-segment elevation myocardial infarction (STEMI) hospitalization significantly increases mortality and readmission. While nutritional and inflammatory indicators like the advanced lung cancer inflammation index (ALI) and modified Controlling Nutritional Status (mCONUT) score are gaining attention, their exact association with post-STEMI de novo HF remains unclear. METHODS: This retrospective study (January 2016 to June 2025) included 1598 first-time STEMI patients undergoing percutaneous coronary intervention. Patients were categorized into de novo HF and non-HF groups to evaluate the association of ALI and mCONUT scores with HF development. RESULTS: The HF group exhibited significantly lower ALI and higher mCONUT scores compared to the non-HF group. Multivariate logistic regression identified lower ALI and higher mCONUT scores as independent predictors of HF risk. Receiver operating characteristic analysis demonstrated that mCONUT possessed better predictive performance than ALI, with effects remaining highly consistent across subgroups. Sensitivity analyses and NRI/IDI results confirmed that mCONUT provides independent incremental predictive value beyond traditional risk models (optimism-corrected C-statistic 0.785 vs. 0.751). These associations were independent of admission hemodynamic status (Killip class) and treatment era. CONCLUSION: Both ALI and mCONUT scores are independently associated with in-hospital de novo HF in STEMI patients. The mCONUT score demonstrates superior predictive performance, serving as a promising indicator for early risk stratification.
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Dai et al. (2026) conducted a cohort in First-time ST-segment elevation myocardial infarction (STEMI) (n=1,598). Modified Controlling Nutritional Status (mCONUT) score and Advanced Lung Cancer Inflammation Index (ALI) vs. Lower mCONUT score / higher ALI score (continuous per-unit increment and quartile comparisons) was evaluated on In-hospital de novo heart failure (OR 1.174, 95% CI 1.121-1.230, p=<0.001). Higher mCONUT and lower ALI independently predicted in-hospital de novo heart failure after STEMI, with mCONUT showing superior discrimination.
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