Comparison of the clinical value of inflammatory blood biomarkers in relation to disease severity and survival in chronic heart failure

Background: Chronic heart failure (CHF) is a leading cause of hospitalization among the elderly in developed nations. CHF involves myocardial dysfunction and systemic disturbances, leading to high morbidity and mortality, particularly in the elderly. The New York Heart Association (NYHA) classification is the primary tool for stratifies severity of heart failure by patient-reported symptoms. Inflammation plays a key role in CHF progression, and identifying reliable inflammatory biomarkers is crucial for assessing disease severity and predicting outcomes. Aims: This study aimed to evaluate the diagnostic and predictive value of 27 different inflammatory blood biomarkers in differentiating patients with varying disease severity based on the NYHA classification and to assess their prognostic significance in CHF. Methods: A group of 154 CHF patients (mean age: 72.1 +/- 13.5 years) was retrospectively analyzed. Inflammatory blood biomarkers were correlated with NYHA classification, left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP), NT-proBNP and patient survival. Results: Of 27 biomarkers, lymphocyte-to-CRP ratio (LCR), CRP-to-lymphocyte ratio (CLR) and CRP-to-albumin ratio (CAR) demonstrated highest diagnostic accuracy for distinguishing between NYHA classification (AUC > 0.700). Five biomarkers: CLR, CAR, LCR, CRP-to-hemoglobin ratio (CHR) and neutrophil-to-CRP ratio (NCR) correlates with NYHA, LVEF%, PASP, and NT-proBNP. CAR, CHR and platelet-to-CRP ratio (PCR) were identified as independent factors affecting patient survival. Conclusions: Selected blood inflammatory biomarkers, including CAR, CLR, LCR, CHR, and PCR, which are based on CRP, are valuable for predicting disease severity and survival in CHF, offering potential for enhanced clinical management.