ArticleFrontiers in endocrinology2026
Prognostic significance of the advanced lung cancer inflammation index for long-term mortality in patients with acute myocardial infarction and diabetes.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The advanced Lung Cancer Inflammation Index (ALI) is a novel composite marker integrating nutritional, metabolic, and inflammatory status. This study aimed to investigate the prognostic significance of admission ALI for long-term mortality in patients with acute myocardial infarction (AMI) and concomitant diabetes. Methods: A total of 571 diabetic AMI patients were retrospectively enrolled from the NOAFCAMI-SH registry. Patients were stratified into ALI tertiles (T1-T3). The primary and secondary outcomes were all-cause and cardiovascular mortality, respectively, evaluated over a median follow-up of 2.5 years. Associations were assessed using Kaplan-Meier survival curves, Cox proportional hazards regression, and restricted cubic spline (RCS) models. Results: Compared to the lowest tertile (T1), patients in the highest tertile (T3) exhibited markedly lower rates of all-cause (7.9% vs. 27.8%) and cardiovascular mortality (7.4% vs. 23.6%). In fully adjusted Cox models, higher ALI (T3 vs. T1) was independently associated with a 67% reduction in the risk of all-cause mortality (HR = 0.33, 95% CI: 0.18-0.61, P < 0.001) and a similar significant decrease in cardiovascular mortality. RCS analysis revealed a significant non-linear, L-shaped relationship between continuous ALI and both mortality outcomes (both P for non-linearity < 0.05), with mortality risk rising precipitously below a specific threshold. Furthermore, adding ALI to the established GRACE score modestly improved individual-level risk reclassification and discrimination for all-cause mortality (continuous NRI: 0.228, P = 0.047; IDI: 0.027, P = 0.020). Conclusion: A lower admission ALI independently associated with long-term all-cause and cardiovascular mortality in diabetic AMI patients.As a readily accessible composite biomarker, ALI offers valuable prognostic information that could assist in the early risk stratification of this high-risk population.
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