Lymphocyte‐to‐Monocyte Ratio and All‐Cause Mortality in Populations With Abdominal Aortic Calcification: A Prospective Cohort Study

<b>Objective:</b> The identification of reliable prognostic markers is essential for the effective management of abdominal aortic calcification (AAC). This research focused on assessing whether the lymphocyte-to-monocyte ratio (LMR) correlates with long-term mortality risk in the AAC population. <b>Methods:</b> This analysis included 888 adults with AAC from National Health and Nutrition Examination Survey (NHANES) 2013-2014. Mortality risk was assessed using Cox proportional hazards models and Kaplan-Meier curves. Nonlinear associations between the LMR and mortality were examined with restricted cubic spline (RCS). The predictive ability was evaluated by time-dependent receiver operating characteristic (ROC) analysis. <b>Results:</b> Over median follow-up for 71 months, 145 deaths were recorded. After adjusting for covariates, higher LMR was found to be significantly associated with a reduced risk of all-cause mortality, with a 28% decrease in risk per one-unit increment in LMR (hazard ratio; HR = 0.72, 95% confidence interval (CI): 0.57-0.91, <i>p</i>=0.02). This was consistent across quartiles. A nonlinear relationship was noted; below LMR 4.49, risk decreased (HR = 0.49, 95% CI: 0.40-0.60, <i>p</i> < 0.0001); above it, LMR was not significantly linked to mortality (HR = 1.14, 95% CI: 0.77-1.7, <i>p</i>=0.51). The area under the curve (AUC) for 2-, 4-, and 6-year survival were 0.647, 0.707, and 0.682, respectively. <b>Conclusions:</b> Higher LMR is significantly associated with lower all-cause mortality in individuals with AAC, suggesting its potential utility as a prognostic marker in this population.