Key result
Neutrophil-to-lymphocyte ratio (NLR) demonstrated better predictive value for detecting heart failure than PLR or their product, yielding 87.2% sensitivity and 91.03% specificity at a 2.191 cutoff.
Why the study?
NLR and PLR are established inflammatory indicators in heart failure, but whether their product provides superior predictive ability compared with healthy controls remained unverified.
Do NLR, PLR, and the NLR-PLR product predict the presence of heart failure compared to healthy controls?
Cross-Sectional (n=125)
Do NLR, PLR, and the NLR-PLR product predict the presence of heart failure compared to healthy controls?
p-value: p=0.000
NLR is a strong predictor of heart failure, outperforming PLR and their combined product, suggesting its utility as an accessible inflammatory biomarker.
Background: Neutrophilto-lymphocyte ratio (NLR) and plateletto-lymphocyte ratio (PLR) are important inflammatory indicators used to see the progression of various diseases, including heart failure (HF). Considering the fact that both NLR and PLR are good inflammatory indicators and have predictive values, we hypothesized that their product will have better predictive value in HF. Hence, in the present study, we are aiming at the determination of NLR, PLR, and NLR-PLR product to determine their predictive ability in HF patients compared to healthy-matched subjects. Objectives: The objectives of this study were to compare the NLR, PLR, and the NLR-PLR product in HF patients and controls to estimate the predictive value of these markers in detecting HF. Methods: This study involved 47 HF patients and 78 controls without HF. The NLR, PLR, and the NLR-PLR product were computed as the ratio of neutrophil count to lymphocyte count, as the ratio of platelet count to lymphocyte count, and as multiplication of NLR and PLR, respectively, in HF and compared with controls. The predictive value was calculated using the receiver operating characteristic (ROC) curve. Results: The NLR, PLR, and the NLR PLR product in HF patients were significantly higher compared to those of the controls ( P = 0.000, P = 0.000, P = 0.000, respectively), and even after adjusting with age and sex. The best cutoff value of NLR, PLR, and NLR-PLR product in predicting HF by ROC curve were 2.191 (sensitivity 87.2%; specificity 91.03%), 120.9 (snsitivity 61.7%; secificity 61.54%), and 271.1 (sensitivity 78.72%; specificity 84.62%), respectively. The likelihood ratios for NLR, PLR, and the NLR-PLR product were 9.72, 1.60, and 5.11, respectively. There was an inverse correlation between the NLR, PLR, and NLR PLR product with hemoglobin ( P = 0.002, P = 0.007, P = 137, respectively). Conclusions: NLR, PLR, and NLR PLR products were significantly increased in HF patients than in age-sex adjusted controls. Though NLR had better predictive value than PLR and NLR PLR products.
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Goudappanavar et al. (2025) conducted a cross-sectional in Heart Failure (n=125). Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), and NLR-PLR product vs. Controls without heart failure was evaluated on Predictive value for detecting heart failure (p=0.000). Neutrophil-to-lymphocyte ratio (NLR) demonstrated better predictive value for detecting heart failure than PLR or their product, yielding 87.2% sensitivity and 91.03% specificity at a 2.191 cutoff.
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