Abstract：
This study aimed to investigate the predictive value of advanced lung cancer inflammation index (ALI) for major adverse cardiovascular events (MACEs) in elderly patients with acute coronary syndrome (ACS).A total of 586 ACS patients undergoing percutaneous coronary intervention (PCI) over 65 years old between January 2017 and December 2018 were retrospectively collected. The patients were divided into two groups by the optimal cutoff value of ALI. Spearman rank correlation coefficient was used to evaluate the correlation between ALI and the Global Registry of Acute Coronary Events (GRACE). Time-dependent receiver operating characteristic (ROC) curves, Cox survival analysis, and Kaplan Meier curves were used to assess the predictive value of ALI for MACEs.Spearman\'s nonparametric test revealed a moderate correlation between ALI and the GRACE (r: -0.417, P < 0.001). Time-dependent ROC curves showed that the area under the curve for ALI was 0.751 (95% CI, 0.699-0.798) in predicting MACEs, higher than Geriatric Nutritional Risk Index (0.531, 95% CI 0.435-0.627) and Prognostic Nutritional Index (0.590, 95% CI 0.505-0.676), and for combined diagnostic models (ALI + GRACE) was 0.913, (95% CI 0.875 - 0.942, P < 0.001). Multivariate Cox analysis demonstrated that ALI (HR: 0.974, 95% CI: 0.952-0.996, P = 0.017) was an independent risk factor for MACEs. Kaplan Meier survival analysis showed that the cumulative incidence of MACEs was significantly higher in elderly ACS patients with lower ALI (log-rank test, P < 0.001).ALI could be a nutrition-inflammation indicator with independent predictive value for long-term MACEs of elderly ACS patients after PCI.
摘要：
本研究旨在探讨晚期肺癌炎症指数(ALI)对老年急性冠脉综合征(ACS)患者主要不良心血管事件(MACEs)的预测价值。回顾性收集2017年1月至2018年12月期间接受经皮冠状动脉介入治疗（PCI）的586例65岁以上的ACS患者。根据ALI的最佳临界值将患者分为两组。Spearman等级相关系数用于评估ALI与全球急性冠状动脉事件注册（GRACE）之间的相关性。随时间变化的接收机工作特性(ROC)曲线,Cox生存分析，和KaplanMeier曲线用于评估ALI对MACEs的预测价值。Spearman的非参数检验显示ALI与GRACE之间存在中度相关性（r：-0.417，P<0.001）。时间依赖性ROC曲线显示ALI预测MACEs的曲线下面积为0.751(95%CI,0.699-0.798),高于老年营养风险指数（0.531，95%CI0.435-0.627）和预后营养指数（0.590，95%CI0.505-0.676），联合诊断模型（ALI+GRACE）为0.913，（95%CI0.875-0.942，P<0.001）。多因素Cox分析显示ALI(HR:0.974,95%CI:0.952~0.996,P=0.017)是MACEs的独立危险因素。KaplanMeier生存分析显示，在ALI较低的老年ACS患者中，MACEs的累积发生率明显较高（log-rank检验，P<0.001)。ALI可能是营养-炎症指标，对老年ACS患者PCI术后长期MACE具有独立预测价值。
