title: Prognostic value of neutrophil‑to‑lymphocyte ratio in predicting long-term mortality in patients with ischemic and nonischemic heart failure.
abstract: Previous studies have shown that an elevated neutrophil-to-lymphocyte ratio (NLR) was associated with a poorer long-term prognosis in patients with heart failure (HF).
  
  
  
  We aimed to study the predictive value of the NLR in patients with left ventricular ejection fraction of 35% or lower. The second objective was to establish whether the NLR has the same prognostic value in patients with ischemic and nonischemic HF.
  
  
  
  The study group consisted of a cohort of patients with HF (1387 men, 347 women; median age, 61 years) from the prospective COMMIT-HF registry. The primary endpoint was all-cause mortality. Patients were divided into tertiles based on the NLR values on admission. The first (low), second (medium), and third (high) tertiles were defined as NLR ≤2.04 (n = 578), NLR 2.05-3.1 (n = 578) and NLR >3.1 (n = 578), respectively.
  
  
  
  During long-term follow-up, 443 deaths were reported. The 12-month mortality in patients in the third NLR tertile was almost 3-fold higher compared with those in the first tertile (7.61% vs 20.07%; P <0.001). In a multivariate analysis, the NLR was an independent factor of mortality (hazard ratio [HR], 2.31; 95% confidence interval [CI], 1.82-2.92; P <0.0001). In addition, the multivariate analysis revealed that the third NLR tertile in the ischemic HF group was an independent factor related to longterm mortality (HR, 1.51; 95% CI, 1.11-2.04; P = 0.008). In the nonischemic HF group, the influence of the NLR on long-term survival was not confirmed.
  
  
  
  The association between the NLR and the risk of death in long-term follow-up was confirmed only in the subgroup of patients with ischemic HF.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Wasilewski
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Pyka
authors.forename: Michał
authors.initials: M
authors.lastname: Hawranek
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Osadnik
authors.forename: Anna
authors.initials: A
authors.lastname: Kurek
authors.forename: Michał
authors.initials: M
authors.lastname: Skrzypek
authors.forename: Jacek
authors.initials: J
authors.lastname: Niedziela
authors.forename: Piotr
authors.initials: P
authors.lastname: Desperak
authors.forename: Zofia
authors.initials: Z
authors.lastname: Kułaczkowska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Brzezina
authors.forename: Michał
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gąsior
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011379:Prognosis; D012189:Retrospective Studies