Nomograms Based on the Advanced Lung Cancer Inflammation Index for the Prediction of Coronary Artery Disease and Calcification

Abstract

Aim To develop and validate 3 nomograms incorporating the advanced lung cancer inflammation index (ALI) that can aid in predicting the risk of coronary artery disease (CAD) and coronary artery calcification (CAC). Methods The study enrolled 562 consecutive patients with suspected CAD who underwent coronary computed tomographic angiography between September 2015 and June 2017. Independent risk factors for CAD, CAC, and CAD with CAC were identified via univariate and multivariate analysis, and nomograms were established based on the independent predictors identified. The area under the curve (AUC), calibration curve, and decision curve analysis were used to evaluate the nomograms. Correlations between ALI and other clinical indicators were examined via Spearman correlation analysis. Results In total, 549 patients with suspected CAD who underwent coronary computed tomographic angiography were included. Male sex, hypertension, diabetes, dyslipidemia, ischemic stroke, and ALI were independent predictors of both CAD and CAC. Male sex, hypertension, diabetes, dyslipidemia, and ALI were also identified as independent predictors of CAD with CAC. The AUC values for the nomograms developed using these risk factors were 0.739 (95% confidence interval [CI], 0.693-0.785), 0.728 (95% CI, 0.684-0.772), and 0.717 (95% CI 0.673-0.761), respectively. ALI was negatively correlated with neutrophil-to-lymphocyte ratio and CAC score and positively correlated with serum albumin levels and body mass index (all P < .05). Conclusions ALI is an independent predictor of CAD, CAC, and CAD with CAC. Our ALI-based nomograms can provide accurate and individualized risk predictions for patients with suspected CAD.

Nomograms Based on the Albumin/Neutrophil-to-Lymphocyte Ratio Score for Predicting Coronary Artery Disease or Subclinical Coronary Artery Disease

“…The CCTA criterion for diagnosing CAD was as follows: at least one branch with stenosis ≥50% in the left main, left anterior descending, left circumflex, or right coronary artery. 10 , 22 The CCTA criteria for diagnosing subclinical CAD were as follows: a coronary artery calcium (CAC) score ≥100 AU and/or at least one branch with stenosis ≥50% in the left main, left anterior descending, left circumflex, or right coronary artery. 23–25 The exclusion criteria were as follows: patients with acute coronary syndrome, connective tissue disease, severe valvular heart disease, hypertrophic cardiomyopathy, and constrictive pericarditis.…”

“… 9 Therefore, recent studies have focused on the peripheral blood inflammatory cell count and its derived indicators, which are easy to measure and can also predict the severity of the disease. 10 The neutrophil-to-lymphocyte ratio (NLR) is a marker of exacerbated systemic inflammation, which has been associated with CAD in previous studies. 11 , 12 Recently few studies have reported that the novel albumin/NLR score (ANS), which combines the NLR and albumin level, has shown prognostic value for patients with colorectal cancer and patients after mandibulofacial reconstruction with a fibula flap.…”

Postoperative Prognostic Nutritional Index and Fibrinogen Could Well Predict Poor Prognosis of Acute Type A Aortic Dissection Patients After Surgery

“…Patients with a lower preoperative PNI showed significantly higher in-hospital mortality, a higher proportion of prolonged mechanical ventilation (MV), and longer intensive care unit (ICU) stay after surgery for ATAAD [ 10 , 11 ] . In addition, several new biomarkers derived from NLR were correlated with systemic inflammation and immune status and were good prognostic indicators of malignant tumors and cardiovascular diseases, including systemic inflammation response index (SIRI), advanced lung cancer inflammation index (ALI), and pan-immune-inflammation value (PIV) [ 12 , 13 ] . These indices outperformed other well-known peripheral blood parameters.…”

Advanced Lung Cancer Inflammation Index for Predicting Prognostic Risk for Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“… 13–15 Our previous study using ALI-based nomograms also showed the diagnostic significance of ALI. 16 …”