The Correlation between NLR,MLR,PLR,SII in Patients with Chronic Heart Failure and Traditional Chinese Medicine Syndromes as well as Prognosis

DENG Huan; CHEN Lifang; LUO Xiaojun; DING Wenli; YU Rong; LIANG Hongyu

doi:10.12102/j.issn.1672-1349.2025.21.017

Abstract：Objective: To explore the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and platelet count × neutrophil/lymphocyte (SII) with TCM syndrome types and prognosis in patients with chronic heart failure. Methods: A total of 155 patients hospitalized in the Department of Cardiology at Guangdong Provincial Second Traditional Chinese Medicine Hospital from January 2022 to January 2023 and diagnosed with chronic heart failure were selected as the study subjects. The patients were divided into groups according to different TCM syndrome types, New York Heart Association (NYHA) functional classes, and whether major adverse cardiovascular events (MACE) occurred within six months after discharge. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of NLR, MLR, PLR, and SII for the prognosis of patients with chronic heart failure, and the Youden index was used to determine the optimal cutoff values. Results: There were statistically significant differences in the levels of NLR, PLR, MLR, and SII among different NYHA functional classes (P < 0.05). The levels of NLR, PLR, MLR, and SII were significantly different between the MACE group and the non-MACE group (P < 0.05). Spearman correlation analysis showed that NLR (r = 0.409, P < 0.05), PLR (r = 0.389, P < 0.05), MLR (r = 0.267, P < 0.05), and SII (r = 0.456, P < 0.05) were positively correlated with the occurrence of MACE within six months after discharge. The areas under the curve (AUC) for predicting MACE events by NLR, MLR, PLR, and SII were 0.792, 0.690, 0.777, and 0.825 (all P < 0.05), respectively. The optimal cutoff values for predicting MACE events were 3.551, 0.480, 184.041, and 713.276 × 10^9/L for NLR, MLR, PLR, and SII, respectively. The sensitivities were 0.650, 0.455, 0.553, and 0.650, and the specificities were 0.844, 0.906, 0.937, and 0.906, respectively. The Youden indices were 0.494, 0.361, 0.490, and 0.556, respectively. Conclusion: The levels of NLR, MLR, PLR, and SII are significantly related to different TCM syndrome types and NYHA functional classes in patients with chronic heart failure. NLR, MLR, PLR, and SII show good predictive performance for MACE events occurring within six months after discharge in patients with chronic heart failure.