This is reflected by a steady immune activation and low-grade inflammation in response to various stimuli including hypoxia, proinflammatory cytokines, and neurohormonal activation ( 4, 5). Comparable to cancer, previous research emerges that show that elevated inflammatory markers are characteristic in patients with HFrEF and correlate with disease severity and prognosis ( 2, 3). Heart failure with reduced ejection fraction (HFrEF) is a major cause of morbidity and mortality in developed countries ( 1).
For PNI and PLR, the association with increase in risk per increment was even stronger in HFrEF than in malignant disease. cancer) was observed for PNI ( p interaction = 0.013) or PLR ( p interaction = 0.005), respectively, with higher increase in risk per inflammatory score increment for HFrEF.Ĭonclusion: In crude models, the inflammatory scores NLR, MLR, PLR, and PNI are associated with severity of disease in HFrEF and with survival in HFrEF similarly to cancer patients. A significant interaction with disease (HFrEF vs. Kaplan–Meier analysis confirmed the discriminatory power of all scores in the HFrEF and the oncologic study population, respectively (log-rank p ≤ 0.026 for all scores). In both disease entities, all scores were associated with all-cause mortality ( p ≤ 0.014 for all scores). In oncologic patients, association with tumor stage was significant for the PNI only ( p = 0.035).
In HFrEF, there was a strong association between all scores and disease severity reflected by NT-proBNP and NYHA class ( p ≤ 0.001 for all). Results: Between 20, a total of 818 patients (443 HFrEF and 375 cancer patients) were enrolled. Interaction analysis was performed for the different populations. Association of scores with disease severity and impact on overall survival was determined. The neutrophil-to-lymphocyte-ratio (NLR), the monocyte-to-lymphocyte-ratio (MLR), the platelet-to-lymphocyte-ratio (PLR), and the prognostic nutritional index (PNI) at index day were calculated. Methods: HFrEF and cancer patients were prospectively enrolled. Objectives: We investigated the impact of established inflammation-based scores on disease severity and survival in patients with stable heart failure with reduced ejection fraction (HFrEF) paralleling results to an intra-institutional cohort of treatment naïve cancer patients. Background: Inflammation-based scores are widely tested in cancer and have been evaluated in cardiovascular diseases including heart failure.
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