Prognostic value of 9 immune-inflammatory markers for patients with dilated cardiomyopathy: A retrospective study.

OBJECTIVE

The study aimed to evaluate the prognostic value of 9 immune-inflammatory markers based on blood cell counts in patients with dilated cardiomyopathy (DCM).

METHODS

A total of 953 DCM patients from the First Affiliated Hospital of Xinjiang Medical University from 2017 to 2021 were selected. Clinical data and test results were collected for retrospective analysis to assess the relationship between various combinations of inflammatory biomarkers derived from neutrophil count, lymphocyte count, monocyte count, and platelet count with the 3-year all-cause mortality risk of DCM. Logistic regression, receiver operating characteristic curve analysis (ROC), restricted cubic spline (RCS) curve analysis were used to evaluate the association between different inflammatory markers and survival outcomes. The net reclassification index (NRI) and integrated discrimination improvement (IDI) were employed to assess the enhancement of each inflammatory index on the Meta-Analysis Global Group in Chronic Heart Failure Risk Score (MAGGIC).

RESULTS

A total of 105 patients (11.02%) with DCM experienced all-cause mortality within 3 years. Multivariate logistic regression analysis suggested that NM (OR: 1.18, 95% CI: 1.05 ∼ 1.33, P = 0.005), NP (OR: 1.01, 95% CI: 1.01 ∼ 1.01, P < 0.001), MP (OR: 1.01, 95% CI: 1.01 ∼ 1.01, P = 0.004), NLR (OR: 1.44, 95% CI: 1.29 ∼ 1.60, P < 0.001), MLR (OR: 14.58, 95% CI: 5.30 ∼ 40.09, P < 0.001), PLR (OR: 1.01, 95% CI: 1.01-1.02, P < 0.001), SIRI (OR: 1.46, 95% CI: 1.29 ∼ 1.66, P < 0.001) and SII (OR: 1.00, 95% CI: 1.00-1.00, P < 0.001), AIRI (OR: 1.01, 95% CI: 1.01 ∼ 1.01, P < 0.001) were important risk factors for all-cause mortality in DCM. NLR, PLR, SII, SIRI and AIRI showed good predictive capability (AUC all >0.70), and RCS curve analysis indicated an overall upward trend in mortality risk with increasing NLR, PLR, SII, SIRI, and AIRI (P < 0.05). Incorporating NLR, PLR, SIRI, SII, and AIRI into the MAGGIC score substantially enhanced its predictive capacity (P < 0.05), as evidenced by notable increases in NRI and IDI levels (P < 0.05).

CONCLUSION

The immune-inflammation indices derived from blood cell counts were closely linked to the 3-year all-cause mortality risk in patients with DCM. The integration of MAGGIC with NLR, PLR, SIRI, SII, and AIRI provides a more precise prediction of DCM prognosis.