Ren Zijuan, Xu Fei, Wei Zheng
Department of Cardiology, Suzhou Municipal Hospital of Anhui Province Suzhou 234000, Anhui, China.
Am J Transl Res. 2025 Jul 15;17(7):4964-4975. doi: 10.62347/XQNT2355. eCollection 2025.
To evaluate the application value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume to lymphocyte ratio (MPVLR) levels in identifying recent major cardiovascular adverse events (MACE) in elderly patients with heart failure (HF).
A total of 103 elderly HF patients admitted to Suzhou Hospital affiliated to Anhui Medical University from January 2022 to February 2025 were selected as the model group, and 74 patients from the same period served as the external validation group. All patients were followed up for 3 months after treatment. Patients were categorized into a MACE group and a non-MACE group based on the occurrence of MACE. Clinical data and levels of NLR, PLR, and MPVLR, were compared between the two groups. Multivariate logistic regression analysis was conducted to identify the independent risk factors for recent MACE. A forest plot was drawn using Graphpad Prism 8.0 software. Predictive models were evaluated using receiver operating characteristic (ROC) curves and calibration curves.
Patients in the MACE group were older and had a higher prevalence of diabetes compared to the non-MACE group. Levels of NLR, PLR, and MPVLR were significantly elevated in the MACE group. Multivariate logistic regression analysis identified NLR ( = 7.928, 2.633-23.869), PLR ( = 1.077, 1.038-1.117), MPVLR ( = 1.688, 1.134-2.513) as risk factors for recent MACE in elderly HF patients (all < 0.05). ROC curve analysis showed that the combined use of NLR, PLR, and MPVLR had superior predictive performance compared to individual indicators ( < 0.05). The predictive model demonstrated superior discriminative ability compared to individual indicators (AUC = 0.919), which was further validated in the external validation group (AUC = 0.810), indicating consistent predictive accuracy.
Elevated levels of NLR, PLR, and MPVLR can serve as independent risk factors for assessing the risk of recent MACE in elderly HF patients. The combined predictive model demonstrates high accuracy and may assist in early risk stratification and personalized preventive strategies to reduce the risk of MACE.
评估中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及平均血小板体积与淋巴细胞比值（MPVLR）水平在识别老年心力衰竭（HF）患者近期主要心血管不良事件（MACE）中的应用价值。
选取2022年1月至2025年2月在安徽医科大学附属苏州医院收治的103例老年HF患者作为模型组，同期74例患者作为外部验证组。所有患者治疗后随访3个月。根据MACE的发生情况将患者分为MACE组和非MACE组。比较两组的临床资料以及NLR、PLR和MPVLR水平。进行多因素logistic回归分析以确定近期MACE的独立危险因素。使用Graphpad Prism 8.0软件绘制森林图。采用受试者工作特征（ROC）曲线和校准曲线评估预测模型。
与非MACE组相比MACE组患者年龄更大且糖尿病患病率更高。MACE组的NLR、PLR和MPVLR水平显著升高。多因素logistic回归分析确定NLR（ =7.928, 2.633 - 23.869）、PLR（ =1.077, 1.038 - 1.117）、MPVLR（ =1.688, 1.134 - 2.513）为老年HF患者近期MACE的危险因素（均 <0.05） ROC曲线分析显示与单个指标相比NLR、PLR和MPVLR联合使用具有更好的预测性能（ <0.05）。预测模型显示出比单个指标更好的判别能力（AUC =0.919）在外部验证组中得到进一步验证（AUC =0.810）表明预测准确性一致。
NLR、PLR和MPVLR水平升高可作为评估老年HF患者近期MACE风险的独立危险因素。联合预测模型显示出较高的准确性可能有助于早期风险分层和个性化预防策略以降低MACE风险。
