The relationship between composite inflammatory indicators and short-term outcomes in patients with heart failure

Inflammatory markers are considered reliable indicators for predicting adverse outcomes of cardiovascular disease. However, the prognostic significance of composite inflammatory indicators such as the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and inflammatory prognosis index (IPI), in predicting mortality among heart failure (HF) patients remains unknown.

We analyzed data from 1981 patients with HF. The composite inflammatory indicators were calculated based on laboratory test. The endpoint of the study was mortality within six months of follow-up. Cox proportional hazards model and restricted cubic spline analysis were used to assess the association between inflammatory markers and outcomes. The incremental predictive value of composite inflammatory indicators was evaluated using C-index, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

SII, SIRI, and IPI were linearly associated with the risk of death. Compared to the first tertile, the hazard ratios and 95 % confidence intervals (CIs) for mortality in patients in the third tertile for SII, SIRI, and IPI were 2.32 (1.15-4.67), 3.59 (1.56-8.26), and 4.16 (1.20-14.41), respectively. Incorporating composite inflammatory indicators into the basic model significantly enhanced outcome prediction, with IPI showing the greatest incremental predictive value, as indicated by an increase in C-index (0.042, 95 % CI: 0.004-0.095), a continuous NRI of 0.712 (95 % CI: 0.360-1.063, P < 0.001), and an IDI of 0.010 (95 % CI: 0.001-0.019, P = 0.030).

Among patients with HF, elevated levels of SII, SIRI, and IPI were significantly associated with an increased risk of six-month mortality, with IPI providing the greatest incremental predictive value.