Prognostic value of advanced lung cancer inflammation index in predicting 1-year mortality post-PCI in STEMI patients

Abstract Background The advanced lung cancer inflammation index(ALI) assesses inflammation and nutritional status across various malignancies, heart failure, and acute coronary syndromes. Purpose To explore the prognostic significance of ALI in patients experiencing ST-elevation myocardial infarction(STEMI) who are treated with primary percutaneous coronary intervention (pPCI), while comparing it to that the well-established Neutrophil-Lymphocyte Ratio(NLR). Methods 1,171 STEMI patients who underwent pPCI were retrospectively enrolled; ALI was calculated using the formula serum albumin (g/dL)×body mass index (kg/m2)/NLR at the time of hospital admission. The primary endpoint evaluated was 1-year all-cause mortality. Results Among the 1,171 patients, 86 fatalities occurred during the follow-up period. Univariate analysis identified age, female gender, hypertension, diabetes, prior myocardial infarction(PMI), lower left ventricular ejection fraction(LVEF), and diminished ALI as mortality-associated factors. Multivariate analysis confirmed PMI(HR:2.4,95% CI:1.4–4.3,p=0.001) and age(HR:1.1,95% CI:1.05–1.11,p0.001) as significant independent predictors, in addition to ALI(HR: 0.95, 95% CI: 0.92–0.97, p0.001) and LVEF(HR:0.98, 95% CI: 0.97–0.99,p=0.04). An ALI threshold of ≤10 indicated an elevated mortality risk(HR: 2.3,95% CI:1.5–3.7,p 0.001). The area under the curve for ALI(0.732) exceeded that for NLR(0.685). Conclusions ALI is an independent prognostic factor for all-cause mortality in STEMI patients undergoing pPCI, exhibiting greater discriminatory power than NLR.Kaplan–Meier survival curves Graphical Abstract