Introduction. The inflammatory response plays a potential role for the pathogenesis and adverse outcomes of heart failure (HF). We aimed to explore the predictive role of baseline neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume-to-lymphocyte ratio (MPVLR) on cardiovascular events (CVEs) in patients hospitalized with acute HF. Materials and Methods. A retrospective cohort study was conducted in 321 patients with HF between January 2017 and December 2019. The association between their NLR, MPVLR, and combined NLR and MPVLR and CVEs, rehospitalization for HF, in-hospital death, and a composite outcome was explored by survival analysis using a Cox proportional hazard model. They were separately investigated and compared with the area under the receiver operating characteristics curve (AUC). Results. Up to the end of the 3-year follow-up, 96 (29.9%) had CVEs, 106 (33.0%) died, 62 (19.3%) were rehospitalized with HF, and 21 (6.5%) died during admission. The NLR and MPVLR were significantly associated with CVEs (adjusted HR for NLR ≥ 3.29 , 3.11; 95% CI, 1.98-4.89; MPVLR ≥ 8.57 , 2.86; 95% CI, 1.87-4.39), readmissions for HF (adjusted HR for NLR ≥ 3.58 , 2.70; 95% CI, 1.58-4.61; MPVLR ≥ 6.43 , 2.84; 95% CI,1.59-5.07), in-hospital mortality (adjusted HR for NLR ≥ 3.29 , 9.54; 95% CI, 2.19-41.40; MPVLR ≥ 8.57 , 7.87; 95% CI, 2.56-24.19), and composite outcome (adjusted HR for NLR ≥ 3.32 , 4.76; 95% CI, 3.29-6.89; MPVLR ≥ 7.07 , 3.64; 95% CI, 2.58-5.15). The AUC of NLR and MPVLR for CVEs were 0.67 (95% CI, 0.61-0.72) and 0.63 (95% CI, 0.58-0.69). Combined NLR and MPVLR increased the AUC to 0.77 (95% CI, 0.72-0.83) with statistical significance. Conclusion. The elevated NLR and MPVLR on admission in patients with acute HF were independently associated with worse CVEs, rehospitalization for HF, in-hospital death, and composite outcomes. These economical biomarkers should be considered in the management and follow-up care of patients with acute HF.

Introduction The inflammatory response plays a potential role for the pathogenesis and adverse outcomes of heart failure (HF). Purpose We aimed to explore the predictive role of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume to lymphocyte ratio (MPVLR) on cardiovascular events (CVEs) in patients hospitalized with acute HF. Methods A retrospective cohort study was conducted in 321 patients with HF between January 2017 and December 2019. The association between their NLR, MPVLR and combined NLR and MPVLR, and CVEs, HF re-hospitalization, in-hospital death, and a composite outcome were explored by survival analysis using a Cox proportional hazard model. They were separately investigated and compared with the area under the receiver operating characteristics curve (AUC). Results Up to the end of the 3-year follow-up, 96 (29.9%) had CVEs, 106 (33.0%) died, 62 (19.3%) were re-hospitalized with HF, and 21 (6.5%) died during admission. The NLR and MPVLR were significantly associated with CVEs (adjusted HR for NLR ≥3.29, 3.11; 95% CI, 1.98–4.89, MPVLR ≥8.57, 2.86; 95% CI, 1.87–4.39), HF readmission (adjusted HR for NLR ≥3.58, 2.70; 95% CI, 1.58–4.61, MPVLR ≥6.43, 2.84; 95% CI,1.59–5.07), in-hospital mortality (adjusted HR for NLR ≥3.29, 9.54; 95% CI, 2.19–41.40, MPVLR ≥8.57, 7.87; 95% CI, 2.56–24.19), and composite outcome (adjusted HR for NLR ≥3.32, 4.76; 95% CI, 3.29–6.89, MPVLR ≥7.07, 3.64; 95% CI, 2.58–5.15). The AUC of NLR and MPVLR for CVEs were 0.67 (95% CI, 0.61–0.72), and 0.63 (95% CI, 0.58–0.69). Combined NLR and MPVLR increased the AUC to 0.77 (95% CI, 0.72–0.83) with statistical significance. Conclusion The elevated NLR and MPVLR on admission in patients with acute HF were independently associated with worse CVEs, HF re-hospitalization, in-hospital death, and composite outcomes. These economical biomarkers should be considered in the management and follow-up care of patients with acute HF. Funding Acknowledgement Type of funding sources: None.