■急性心肌梗死(AMI)并发心源性休克(CS)具有很高的死亡风险。炎症和营养参与AMI和CS的发病和预后。晚期肺癌炎症指数比(ALI)结合了炎症和营养状况。本研究旨在探讨ALI在AMI后CS患者中的预后价值。
■总共,根据ALI入院截止值将217例AMI并发CS患者分为两组:≤12.69和>12.69。这项研究的主要终点是30天全因死亡率。次要终点是消化道出血和主要不良心血管事件(MACE),包括30天全因死亡率,房室传导阻滞,室性心动过速/心室颤动,和非致命性中风.通过Cox回归分析分析ALI与研究终点的关联。
■在入院后的30天随访期内,104例(47.9%)患者死亡,150例(69.1%)患者发生MACE。Kaplan-Meier分析显示,与高ALI组相比,低ALI组的累积死亡率显著较高,MACE发生率显著较低(两者的log-rankp<0.001)。与ALI>12.69相比,ALI≤12.69的患者30天死亡率明显更高(72.1%vs.22.6%;p<0.001)。此外,ALI≤12.69患者的MACEs发生率较高(85.6%vs.51.9%;p<0.001)。受试者工作曲线显示ALI具有适度的预测值(曲线下面积[AUC]:0.789,95%置信区间[CI]:0.729,0.850)。经过多变量调整后,ALI≤12.69是30天全因死亡率(风险比[HR]:3.327;95%CI:2.053,5.389;p<0.001)和30天MACE(HR:2.250;95%CI1.553,3.260;p<0.001)的独立预测因子。此外,在包含临床和实验室数据的基础模型中加入ALI,在统计学上提高了预测价值.
■入院时评估ALI水平可以为AMI并发CS患者的短期预后评估提供重要信息。较低的ALI可能是30天全因死亡率和MACE增加的独立预测因子。
UNASSIGNED: Acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) carries a high mortality risk. Inflammation and nutrition are involved in the pathogenesis and prognosis of both AMI and CS. The advanced lung cancer inflammation index ratio (ALI) combines the inflammatory and nutritional status. Our present study aimed to explore the prognostic value of ALI in patients with CS following AMI.
UNASSIGNED: In total, 217 consecutive patients with AMI complicated by CS were divided into two groups based on the ALI admissions cut-off: ≤ 12.69 and > 12.69. The primary endpoint of this study was 30-day all-cause mortality. The secondary endpoints were gastrointestinal hemorrhage and major adverse cardiovascular events (MACEs), including 30-day all-cause mortality, atrioventricular block, ventricular tachycardia/ventricular fibrillation, and nonfatal stroke. The association of ALI with the study endpoints was analyzed by Cox regression analysis.
UNASSIGNED: During the 30-day follow-up period after admission, 104 (47.9%) patients died and 150 (69.1%) suffered MACEs. The Kaplan-Meier analysis revealed significantly higher cumulative mortality and lower MACE rates in the low-ALI group compared to the high-ALI group (both log-rank p < 0.001). The 30-day mortality rate was significantly higher in patients with ALI ≤ 12.69 compared to ALI > 12.69 (72.1% vs. 22.6%; p < 0.001). Furthermore, the incidence of MACEs was higher in patients with ALI ≤ 12.69 (85.6% vs. 51.9%; p < 0.001). The receiver operating curve showed that ALI had a modest predictive value (area under the curve [AUC]: 0.789, 95% confidence interval [CI]: 0.729, 0.850). After multivariable adjustment, ALI ≤ 12.69 was an independent predictor for both 30-day all-cause mortality (hazard ratio [HR]: 3.327; 95% CI: 2.053, 5.389; p < 0.001) and 30-day MACEs (HR: 2.250; 95% CI 1.553, 3.260; p < 0.001). Furthermore, the addition of ALI to a base model containing clinical and laboratory data statistically improved the predictive value.
UNASSIGNED: Assessing ALI levels upon admission can provide important information for the short-term prognostic assessment of patients with AMI complicated by CS. A lower ALI may serve as an independent predictor of increased 30-day all-cause mortality and MACEs.