Prognostic significance of the TyG index combined with the NLR for heart failure: a retrospective study

Background The triglyceride–glucose (TyG) index and the neutrophil–lymphocyte ratio (NLR) are independent prognostic factors in patients with heart failure, but no studies have explored the predictive value of the TyG index combined with the NLR (TyG-NLR) for all-cause mortality in patients with heart failure. Methods A total of 1,063 patients with HF admitted to the First Affiliated Hospital of Kunming Medical University from January 2017 to October 2021 were enrolled in the study. Based on the median of TyG-NLR, patients were divided into a low TyG-NLR group (TyG-NLR 5.93) and a high TyG-NLR group (TyG-NLR ≥ 5.93) and 4 subgroups according to the median TyG and NLR (Group 1: TyG 1.79 + NLR 3.31; Group 2: TyG 1.79 + NLR ≥ 3.31; Group 3: TyG ≥ 1.79 + NLR 3.31; Group 4: TyG ≥ 1.79 + NLR ≥ 3.31). We used Kaplan–Meier curves, Cox survival analyses, ROC curves, NRI, IDI, and DCA to explore the predictive value of the TyG-NLR for all-cause mortality in HF patients. Results According to the Kaplan–Meier analysis, those with higher TyG indices and NLRs (TyG ≥ 1.79 and NLR ≥ 3.31) had significantly higher mortality rates than the other patients. By univariate and multivariate Cox proportional hazards analyses, we identified the TyG-NLR as an independent predictor of all-cause mortality in patients with CHF. In the subgroup analysis, the risk of death and all-cause mortality rates were 2.033 times higher in Group 2 ( p 0.001), 1.486 times higher in Group 3 ( p = 0.018), and 2.984 times higher in Group 4 ( p 0.001), with Group 1 being the reference group. In addition, the receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) analysis revealed that the model with the TyG-NLR is superior to the traditional model in predicting all-cause mortality in patients with HF. Conclusions Our findings demonstrate that an increased TyG-NLR is an independent predictor of increased mortality in patients with HF.