Heart failure

A New HFpEF Prognostic Tool Is Investigated

Advanced lung cancer inflammation index predicts prognosis in patients with heart failure with preserved ejection fraction (HFpEF), according to new data presented at American Heart Association Scientific Sessions 2021.

The Advanced Lung Cancer Inflammation Index (ALI), which can be used to determine the prognosis of patients with malignancies by measuring malnutrition and inflammation, is the body mass index multiplied by the serum albumin level over the neutrophil to lymphocyte ratio. To assess the value of the ALI in determining prognosis in patients with HFpEF, researchers from Japan extracted patient data from the registry of Osaka’s Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF).

The study group consisted of 821 patients with advanced heart failure; 45% were men, and the group’s mean age was 81 years. The researchers calculated the ALI for each patient. The study’s primary endpoint was all-cause death. Its mean follow‑up period was 1.8 years, during which 169 patients had died.

Multivariate Cox analysis showed that the ALI was significantly associated with all‑cause death after adjustment for sex, New York Heart Association functional class, systolic blood pressure, serum creatinine level, serum C-reactive protein level, history of atrial fibrillation, and left ventricular ejection fraction. This association was independent of age, serum sodium level, hemoglobin level, and serum N-terminal pro-hormone B-natriuretic peptide level.

In addition, based on Kaplan-Meier curve analysis, patients in the tertile with the lowest ALI (24.16 or less) had a greater risk of all-cause death (32%) than those in the tertile with the highest ALI (> 40.1; 13% risk).

As a result, the researchers concluded “ALI, a systemic inflammation-nutrition index, might be useful for stratifying [advanced heart failure] patients with HFpEF at risk for total mortality.”

—Ellen Kurek


Sakamoto D, Seo M, Yamada T, et al; the OCVC-Heart Failure Investigators. Usefulness of a systemic inflammation-nutrition index for the prediction of post discharge prognosis in patients with heart failure with preserved ejection fraction: insights from Pursuit-HFpEF Registry. Paper presented at: American Heart Association Scientific Sessions 2021; November 13-15, 2021; Virtual. https://www.abstractsonline.com/pp8/?_ga=2.35875360.1285494533.1632235753-403355333.1630439276#!/9349/presentation/969