Association between lactate/albumin ratio and mortality in patients with heart failure after myocardial infarction

AIMS: Lactate/albumin ratio (L/A) is a recognized prognostic index of patients with heart failure (HF) after myocardial infarction (MI). We aim to evaluate the prognostic value of L/A ratio in predicting in‐hospital mortality for those patients. METHODS AND RESULTS: We enrolled qualified patients from Medical Information Mart for Intensive Care IV database for retrospective study. A receiver operating characteristic (ROC) curve of the subjects was applied to determine the predicted value and the best cut‐off value of L/A on admission. Univariate/multivariate Cox regression analysis and restricted cubic splines (RCS) were performed to identify the association between hospital admission and hospital mortality. The Kaplan–Meier (KM) method was used to draw the survival curve of the two groups with different L/A levels at admission. L/A values at admission were significantly higher in the death groups than the survival groups [1.36 (1.20) vs. 0.62 (0.36), P < 0.05], and area under the ROC curve [0.780 (95% confidence interval, 0.772–0.827)] was better than other indicators, and the best the cut‐off value was 0.671. Data of Cox regression analysis showed that higher L/A value supposed to be an independent risk factor for in‐hospital mortality. RCS analysis showed evidence of an increasing trend and a non‐linear relationship between L/A and in‐hospital mortality (P value was non‐linear <0.05). KM survival curves were significantly lower in the high L/A group than the low L/A group (P < 0.001), and the former group had an increased risk of in‐hospital mortality compared with the latter one (log rank P < 0.001). CONCLUSIONS: Elevated L/A ratio on admission is an independent predictor of high in‐hospital mortality in post‐MI heart failure patients, which proved to be better than lactate, Sequential Organ Failure Assessment score and other related indicators.