Laboratory Parameters Predicting Mortality in Heart Failure Patients treated with Implantable Cardioverter Defibrillator: Single Centre, Long-term Results

Objectives: Neutrophil/lymphocyte (NLR), Monocyte/HDL (MHR), lymphocyte/monocyte (LMR) and platelet/lymphocyte ratios (PLR) are inflammation markers with proven prognostic values in various cardiovascular diseases.However, a clinical study demonstrating the prognostic value of these markers in heart failure (HF) patients treated with an implantable cardioverter-defibrillator (ICD) is not yet available.It is aimed to demonstrate the relationship between NLR, MHR, LMR, PLR and mortality development in patients with HF with ICD. Materials and Methods: One hundred and ninety-four patients who underwent ICD implantation due to systolic HF between January 2015 and December 2019 were included in the study.Results: The mean age was 59.84±13.26years.The female gender ratio was 25.3%.Death developed in 16 patients (8%) after a median follow-up of 27 months.While basal urea, uric acid, gamma-glutamyl transferase, C-reactive protein and neutrophil levels were found to be high, hemoglobin and lymphocyte levels were found to be low in the exitus developing group.While the rates of NLR, MHR and PLR were statistically significantly higher in the group with death during follow-up (p=0.001,p=0.049, p=0.020, respectively ), LMR was significantly lower (p<0.001).In ROC analyses, mortality was predicted with 81% sensitivity and 61% specificity (p=0.001AUC=0.76) of values of NLR and above 3.06; 86% sensitivity and 61% specificity [p=0.046Area under curve (AUC)=0.723] of values of MHR and above 0,0196; 81% sensitivity and 55% specificity (p<0.001AUC=0.784) of values of LMR 3.22 and 113.59 and above of PLR with 75% sensitivity and 51% specificity (p=0.020AUC=0.68).Multiple logistic regression analysis showed LMR was an independent factor for mortality (p=0.027).Conclusion: In our study, it has been shown that NLR, MHR, PLR and LMR, which are inflammation markers, can predict mortality in patients with ICD implanted HF.In the multivariate analysis, LMR value has been found to be significant.This is the first study demonstrating the predictive power of these parameters in this patient group.