Abstract 11752: Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients Admitted With Acute Decompensated Heart Failure; A Comparison With Platelet to Lymphocyte Ratio and Glasgow Prognostic Score
Backgrounds: Inflammation plays a critical role in the outcomes of heart failure. As indicators of the systemic inflammatory response, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed to predict the poor outcome in patients (pts) with acute coronary syndrome. Furthermore, as another systemic inflammation-based score, the Glasgow Prognostic Score (GPS) has recently been reported to provide prognostic information in pts with heart failure. However, there is no information available on the comparison of prognostic impacts of these systemic inflammatory indices in pts admitted with acute decompensated heart failure (ADHF).
Methods and Results: We studied 305 consecutive ADHF pts discharged with survival. At the admission and discharge, NLR and PLR were measured and GPS (0,1 and 2) was also obtained by combining elevated CRP (>1mg/dl) and hypoalbuminemia(<3.5g/dl) (none=0, either=1, and both=2). During a follow up period of 4.2±3.3 yrs, 96 pts died. Neither NLR nor PLR at the admission showed an association with mortality. At multivariate Cox analysis, NLR at the discharge (p=0.01) was significantly associated with mortality, independently of age, systolic blood pressure, prior heart failure hospitalization, and serum sodium level, although PLR (p=0.01) and GPS (p=0.02) at the discharge showed a significant association with mortality at univariate analysis. By ROC analysis, AUC of NLR at the discharge was 0.705 (0.639-0.772, p<0.0001), which was greater than those of PLR (0.615[0.544-0.687], p=0.002) and GPS (0.567[0.490-0.644], p=0.09) at the discharge. Pts with highest tertile of NLR (>2.2) had a increased risk of mortality than middle tertile (NLR=2.2-1.5; HR 2.0 [1.3-3.3]) and lowest tertile (NLR<1.5: HR 4.4 [2.5-7.9]).
Conclusion: NLR at the discharge provides more valuable prognostic value for the prediction of total mortality than PLR and GPS in ADHF pts.
Author Disclosures: T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. M. Ishimi: None. H. Hakui: None. T. Ozaki: None. Y. Satoh: None. M. Seo: None. M. Fukunami: None.
- © 2015 by American Heart Association, Inc.