Prognostic value of lymphocyte to C-reactive protein ratio for cardiovascular and all-cause mortality in adults with congestive heart failure in the United States: NHANES 1999-2010.

BACKGROUND

Lymphocyte to C-reactive protein ratio (LCR) is an emerging inflammatory biomarker, but its association with prognosis in individuals with congestive heart failure (CHF) remains unclear. We sought to evaluate the relationship between LCR and cardiovascular (CV) and all-cause mortality in individuals diagnosed with CHF.

METHODS

We included 718 CHF individuals, using NHANES 1999-2010 data. ROC curves were used to compare the prognostic value of LCR, C-reactive protein, and lymphocyte counts for 3-year, 5-year, and 10-year CV and all-cause mortality risk. The population was divided into 4 groups based on the value of LCR according to the quartile. Prognosis analysis utilized the Kaplan-Meier method and Cox-regression analysis while accounting for NHANES recommended weights.

RESULTS

Kaplan-Meier curves demonstrated a significantly worse prognosis in the low LCR group compared to the high LCR group (log-rank test; p < 0.001). For 3-year CV mortality, the multivariable-adjusted hazard ratios [95 % confidence interval] for LCR quartiles (Q 2,3,4 vs Q 1) were 0.43 (0.21-0.87), 0.38 (0.13-1.07), 0.34 (0.13-0.88), (P for trend = 0.033). For 3-year all-cause mortality, aHRs were 0.36 (0.22-0.60), 0.51 (0.29-0.89), 0.35 (0.18-0.64), (P for trend = 0.002). Similar findings were observed for 5- and 10-year CV and all-cause mortality.

CONCLUSIONS

Elevated LCR emerged as an independent prognostic factor for CV and all-cause mortality in individuals with CHF. Moreover, the implementation of anti-inflammatory therapy exhibits the potential to improve outcomes for decreased LCR patients with CHF.