Prognostic value of advanced lung cancer inflammation index (ALI) combined with geriatric nutritional risk index (GNRI) in patients with chronic heart failure

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][1] 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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study was funded by the Yunnan Provincial Health Commission Clinical Medical Center (ZX2019-03-01) and by the Applied Basic Research Program of the Science and Technology Hall of Yunnan Province and Kunming Medical University (Project No. 202301AY070001-130). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Kunming Medical University, and the study complied with the Declaration of Helsinki. Written informed consent was obtained from each patient in the study. The ethics number of the study was (2022) Ethics L No.173. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All the data involved in the manuscript are available. [1]: #ref-2