Association between inflammatory burden index and risk of heart failure: evidence from NHANES 2003–2017

BACKGROUND: Systemic inflammation contributes to the progression of heart failure (HF). This study aims to investigate the association between inflammatory burden index (IBI) and HF risk. METHODS: In this cross-sectional study of NHANES 2003-2017, data from 19,856 participants were analyzed, including 652 participants with HF and 19,204 without HF. Participants were categorized into quartiles based on IBI levels (Q1-Q4). The risk of HF across these quartiles was assessed with adjustment for potential confounders and restricted cubic spline analyses were used to evaluate dose-response relationships. RESULTS: Our results show that participants with HF have higher IBI levels compared to those without HF (2.66 ± 0.27 vs. 1.05 ± 0.03, p < 0.001). The prevalence of HF increases with higher IBI quartiles: Quartile 1 (1.2%), Quartile 2 (1.33%), Quartile 3 (2.60%), and Quartile 4 (4.37%) (p < 0.001). After adjusting for potential confounders, the risk of HF remained elevated across the quartiles: Quartile 2 (odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.48-1.10), Quartile 3 (OR = 1.06, 95% CI: 0.70-1.61), and Quartile 4 (OR = 1.46, 95% CI: 1.02-2.10) compared to Quartile 1. Restricted cubic spline analysis further confirmed a substantial positive-linear correlation between IBI and HF risk. CONCLUSION: Higher levels of IBI are related to a high risk of HF, independent of traditional risk factors. These results suggest that IBI could be a useful parameter for identifying individuals at higher risk of HF. CLINICAL TRIAL NUMBER: Not applicable.