Predictive value of the advanced lung cancer inflammation index on the prognosis of patients after transcatheter aortic valve replacement_West China Medical Journal

Authors：

PENG Shiqin ,  CHEN Mao

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

CHEN Mao, Email: chenmao@scu.edu.cn

Keywords：

Transcatheter aortic valve replacement; advanced lung cancer inflammation index; prognosis; major adverse cardiovascular events

DOI：

10.7507/1002-0179.202603034

Video：

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Objective To explore the predictive value of the advanced lung cancer inflammation index (ALI) for major adverse cardiovascular events (MACE) in patients undergoing transcatheter aortic valve replacement (TAVR). Methods A retrospective analysis was conducted on patients with severe aortic stenosis who underwent TAVR at the Department of Cardiology, West China Hospital of Sichuan University between April 2012 and September 2023. The primary endpoint was MACE. Participants were stratified into different subgroups based on the cutoff value of ALI. Kaplan-Meier survival analysis was used to evaluate the differences in prognosis, and the Cox proportional hazards regression model and restricted cubic spline analysis were used to analyze the relationship between ALI and the risk of MACE. Results A total of 1752 patients were included, with a median follow-up of 2.46 years. In the fully adjusted Cox regression model, each unit increase in ALI was associated with a 2% reduction in the risk of MACE [hazard ratio (HR)=0.98, 95% confidence interval (CI) (0.97, 0.99), P<0.001]. Additionally, compared with the ALI<39.58 group, the ALI≥39.58 group had a 59% lower risk of MACE [HR=0.41, 95%CI (0.30, 0.55), P<0.001]. The restricted cubic spline model indicated a linear relationship between ALI and the risk of MACE (P for overall<0.001, P for non-linear=0.652). Conclusion ALI is significantly associated with MACE in patients after TAVR; ALI≤39.58 is an independent risk factor and can be used as a prognostic indicator for preoperative risk stratification and treatment decision-making.

Citation： PENG Shiqin, CHEN Mao. Predictive value of the advanced lung cancer inflammation index on the prognosis of patients after transcatheter aortic valve replacement. West China Medical Journal, 2026, 41(8): 1282-1288. doi: 10.7507/1002-0179.202603034 Copy

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7.	Mas-Peiro S, Hoffmann J, Seppelt PC, et al. Value of prognostic nutritional index for survival prediction in trans-catheter aortic valve replacement compared to other common nutritional indexes[J]. Acta Cardiologica, 2021, 76(6): 615-622.
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10.	Chen WT, Zhang GH, Lei Q, et al. Prognostic value of advanced lung cancer inflammation index in heart failure patients: a comprehensive analysis[J]. ESC Heart Fail, 2025, 12(3): 2298-2309.
11.	Wang XC, Wei C, Fan WJ, et al. Advanced lung cancer inflammation index for predicting prognostic risk for patients with acute coronary syndrome undergoing percutaneous coronary intervention[J]. J Inflamm Res, 2023, 16: 3631-3641.
12.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease[J]. Eur J Cardiothorac Surg, 2021, 60(4): 727-800.
13.	Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2021, 143(5): e35-e71.
14.	Jabri A, Alameh A, Giustino G, et al. Transcatheter aortic valve replacement is ready for most low-risk patients: a systematic review of the literature[J]. Card Fail Rev, 2024, 10: e11.
15.	Shahim B, Redfors B, Lindman BR, et al. Neutrophil-to-lymphocyte ratios in patients undergoing aortic valve replacement: the PARTNER trials and registries[J]. J Am Heart Assoc, 2022, 11(11): e024091.
16.	Kazemian S, Tavolinejad H, Rashedi S, et al. Meta-analysis on the association between nutritional status and outcomes after transcatheter aortic valve implantation[J]. Am J Cardiol, 2023, 186: 109-116.
17.	Karaca M, Kalyoncuo?lu M, Zengin A, et al. The prognostic value of the advanced lung cancer inflammation index for major cardiovascular and cerebrovascular events in patients with non-ST elevation myocardial infarction undergoing percutaneous coronary intervention[J]. J Clin Med, 2025, 14(5): 1403.
18.	Otto CM, Newby DE, Hillis GS. Calcific aortic stenosis: a review[J]. JAMA, 2024, 332(23): 2014-2026.
19.	Kwak H, Lee E, Karki R. DNA sensors in metabolic and cardiovascular diseases: molecular mechanisms and therapeutic prospects[J]. Immunol Rev, 2025, 329(1): e13382.
20.	Lin H, Xiong W, Fu L, et al. Damage-associated molecular patterns (DAMPs) in diseases: implications for therapy[J]. Mol Biomed, 2025, 6(1): 60.
21.	Maznyczka A, De Backer O, Généreux P, et al. The inflammatory response to transcatheter aortic valve replacement[J]. JACC Cardiovasc Interv, 2025, 18(22): 2685-2700.
22.	Sá MP, Erten O, Ramlawi B. Transcatheter aortic valve implantation in elderly patients with aortic valve stenosis: the role of frailty, malnutrition, and sarcopenia[J]. J Am Heart Assoc, 2022, 11(19): e027705.
23.	Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study[J]. Am J Med, 2020, 133(6): 713-722.e7.
24.	Antar R, Farag C, Xu V, et al. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES[J]. Front Nutr, 2023, 10: 1206958.
25.	Lavie CJ, Alpert MA, Arena R, et al. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure[J]. JACC Heart Fail, 2013, 1(2): 93-102.
26.	Sgura FA, Arrotti S, Monopoli D, et al. Impact of body mass index on the outcome of elderly patients treated with transcatheter aortic valve implantation[J]. Intern Emerg Med, 2022, 17(2): 369-376.

1. Coffey S, Roberts-Thomson R, Brown A, et al. Global epidemiology of valvular heart disease[J]. Nat Rev Cardiol, 2021, 18(12): 853-864.
2. Peters AS, Duggan JP, Trachiotis GD, et al. Epidemiology of valvular heart disease[J]. Surg Clin North Am, 2022, 102(3): 517-528.
3. Zhang Y, Peng SQ, Li WY, et al. Impact of red blood cell transfusion volume on long-term mortality after transcatheter aortic valve replacement[J]. Front Cardiovasc Med, 2025, 12: 1612385.
4. Tamarappoo B, Han D, Tyler J, et al. Prognostic value of computed tomography-derived extracellular volume in tavr patients with low-flow low-gradient aortic stenosis[J]. JACC Cardiovasc Imaging, 2020, 13(12): 2591-2601.
5. Tosu AR, Kalyoncuoglu M, Biter H?, et al. Prognostic value of systemic immune-inflammation index for major adverse cardiac events and mortality in severe aortic stenosis patients after TAVI[J]. Medicina (Kaunas), 2021, 57(6): 588.
6. Li W, Li H, Peng S, et al. Associations between blood cell-based inflammatory indices and their changes and mortality in patients undergoing transcatheter aortic valve replacement: a retrospective investigation with prospective multicenter cohort validation study[J]. Int J Surg, 2025, 112: 9667-9679.
7. Mas-Peiro S, Hoffmann J, Seppelt PC, et al. Value of prognostic nutritional index for survival prediction in trans-catheter aortic valve replacement compared to other common nutritional indexes[J]. Acta Cardiologica, 2021, 76(6): 615-622.
8. Jafri SH, Shi RH, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): a retrospective review[J]. Bmc Cancer, 2013, 13: 158.
9. Chen YY, Guan MQ, Wang RQ, et al. Relationship between advanced lung cancer inflammation index and long-term all-cause, cardiovascular, and cancer mortality among type 2 diabetes mellitus patients: NHANES, 1999-2018[J]. Front Endocrinol (Lausanne), 2023, 14: 1298345.
10. Chen WT, Zhang GH, Lei Q, et al. Prognostic value of advanced lung cancer inflammation index in heart failure patients: a comprehensive analysis[J]. ESC Heart Fail, 2025, 12(3): 2298-2309.
11. Wang XC, Wei C, Fan WJ, et al. Advanced lung cancer inflammation index for predicting prognostic risk for patients with acute coronary syndrome undergoing percutaneous coronary intervention[J]. J Inflamm Res, 2023, 16: 3631-3641.
12. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease[J]. Eur J Cardiothorac Surg, 2021, 60(4): 727-800.
13. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation, 2021, 143(5): e35-e71.
14. Jabri A, Alameh A, Giustino G, et al. Transcatheter aortic valve replacement is ready for most low-risk patients: a systematic review of the literature[J]. Card Fail Rev, 2024, 10: e11.
15. Shahim B, Redfors B, Lindman BR, et al. Neutrophil-to-lymphocyte ratios in patients undergoing aortic valve replacement: the PARTNER trials and registries[J]. J Am Heart Assoc, 2022, 11(11): e024091.
16. Kazemian S, Tavolinejad H, Rashedi S, et al. Meta-analysis on the association between nutritional status and outcomes after transcatheter aortic valve implantation[J]. Am J Cardiol, 2023, 186: 109-116.
17. Karaca M, Kalyoncuo?lu M, Zengin A, et al. The prognostic value of the advanced lung cancer inflammation index for major cardiovascular and cerebrovascular events in patients with non-ST elevation myocardial infarction undergoing percutaneous coronary intervention[J]. J Clin Med, 2025, 14(5): 1403.
18. Otto CM, Newby DE, Hillis GS. Calcific aortic stenosis: a review[J]. JAMA, 2024, 332(23): 2014-2026.
19. Kwak H, Lee E, Karki R. DNA sensors in metabolic and cardiovascular diseases: molecular mechanisms and therapeutic prospects[J]. Immunol Rev, 2025, 329(1): e13382.
20. Lin H, Xiong W, Fu L, et al. Damage-associated molecular patterns (DAMPs) in diseases: implications for therapy[J]. Mol Biomed, 2025, 6(1): 60.
21. Maznyczka A, De Backer O, Généreux P, et al. The inflammatory response to transcatheter aortic valve replacement[J]. JACC Cardiovasc Interv, 2025, 18(22): 2685-2700.
22. Sá MP, Erten O, Ramlawi B. Transcatheter aortic valve implantation in elderly patients with aortic valve stenosis: the role of frailty, malnutrition, and sarcopenia[J]. J Am Heart Assoc, 2022, 11(19): e027705.
23. Eckart A, Struja T, Kutz A, et al. Relationship of nutritional status, inflammation, and serum albumin levels during acute illness: a prospective study[J]. Am J Med, 2020, 133(6): 713-722.e7.
24. Antar R, Farag C, Xu V, et al. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES[J]. Front Nutr, 2023, 10: 1206958.
25. Lavie CJ, Alpert MA, Arena R, et al. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure[J]. JACC Heart Fail, 2013, 1(2): 93-102.
26. Sgura FA, Arrotti S, Monopoli D, et al. Impact of body mass index on the outcome of elderly patients treated with transcatheter aortic valve implantation[J]. Intern Emerg Med, 2022, 17(2): 369-376.

West China Medical Journal

Predictive value of the advanced lung cancer inflammation index on the prognosis of patients after transcatheter aortic valve replacement

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