Association between lactate/albumin ratio and prognosis in patients with acute myocardial infarction

Abstract Background The association between the lactate/albumin ratio (L/A) as a diagnostic indicator and unfavourable clinical outcomes has been established in patients with community‐acquired pneumonia, sepsis and heart failure, but the connection between L/A and all‐cause mortality in patients with acute myocardial infarction (AMI) has yet to be fully understood. Methods This was a retrospective cohort study using MIMIC‐IV (v2.2) data, with 2816 patients enrolled and all‐cause mortality during hospitalization as the primary outcome. Kaplan–Meier (KM) analysis was used to compare the all‐cause mortality between high‐level and low‐level L/A groups. Receiver operating characteristic (ROC) curve, Restricted cubic splines (RCS) and Cox proportional hazards analysis were performed to investigate the relationship between L/A ratio and in‐hospital all‐cause mortality. Results L/A values were significantly higher in the non‐survivor groups than the survival groups (1.14 [.20] vs. .60 [.36], p < .05), and area under the ROC curve [.734 (95% confidence interval, .694–.775)] was better than other indicators. 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 <.05). KM survival curves were significantly lower in the high L/A group than the low L/A group ( p < .001), and the former group had an increased risk of in‐hospital mortality compared with the latter one (Log Rank p < .001). Conclusions L/A demonstrates significant independent predictive power for elevated all‐cause mortality during hospitalization in patients diagnosed with AMI.