Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis

Abstract Aims In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional–inflammatory markers and lymphocyte‐to‐C‐reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physic...

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Main Authors: Daichi Maeda, Yuya Matsue, Nobuyuki Kagiyama, Yudai Fujimoto, Tsutomu Sunayama, Taishi Dotare, Taisuke Nakade, Kentaro Jujo, Kazuya Saito, Kentaro Kamiya, Hiroshi Saito, Yuki Ogasahara, Emi Maekawa, Masaaki Konishi, Takeshi Kitai, Kentaro Iwata, Hiroshi Wada, Masaru Hiki, Takatoshi Kasai, Hirofumi Nagamatsu, Tetsuya Ozawa, Katsuya Izawa, Shuhei Yamamoto, Naoki Aizawa, Kazuki Wakaume, Kazuhiro Oka, Shin‐ichi Momomura, Tohru Minamino
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.14972
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author Daichi Maeda
Yuya Matsue
Nobuyuki Kagiyama
Yudai Fujimoto
Tsutomu Sunayama
Taishi Dotare
Taisuke Nakade
Kentaro Jujo
Kazuya Saito
Kentaro Kamiya
Hiroshi Saito
Yuki Ogasahara
Emi Maekawa
Masaaki Konishi
Takeshi Kitai
Kentaro Iwata
Hiroshi Wada
Masaru Hiki
Takatoshi Kasai
Hirofumi Nagamatsu
Tetsuya Ozawa
Katsuya Izawa
Shuhei Yamamoto
Naoki Aizawa
Kazuki Wakaume
Kazuhiro Oka
Shin‐ichi Momomura
Tohru Minamino
author_facet Daichi Maeda
Yuya Matsue
Nobuyuki Kagiyama
Yudai Fujimoto
Tsutomu Sunayama
Taishi Dotare
Taisuke Nakade
Kentaro Jujo
Kazuya Saito
Kentaro Kamiya
Hiroshi Saito
Yuki Ogasahara
Emi Maekawa
Masaaki Konishi
Takeshi Kitai
Kentaro Iwata
Hiroshi Wada
Masaru Hiki
Takatoshi Kasai
Hirofumi Nagamatsu
Tetsuya Ozawa
Katsuya Izawa
Shuhei Yamamoto
Naoki Aizawa
Kazuki Wakaume
Kazuhiro Oka
Shin‐ichi Momomura
Tohru Minamino
author_sort Daichi Maeda
collection DOAJ
description Abstract Aims In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional–inflammatory markers and lymphocyte‐to‐C‐reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF. Methods and results This study was a secondary analysis of the FRAGILE‐HF study, a prospective observational study conducted across 15 hospitals in Japan. We included 1212 patients (mean age, 80.2 ± 7.8 years; 513 women) hospitalized with HF, who were classified into three groups according to their LCS score: 0 (n = 498), 1 (n = 533), and 2 (n = 181). Baseline data on physical examination, echocardiography, blood test results (including lymphocyte counts and CRP levels), and oral medication usage were collected in a clinically compensated state before discharge. Nutritional status and physical function were evaluated using several indices and tests. The primary outcome of this study was all‐cause death within 2 years. Univariate and multivariate linear regression analyses were performed to evaluate the associations among the nutritional status, physical function, and LCR/LCS. Patients with an LCS score of 2 were older and had a lower body mass index than those in the other two groups. Multivariate linear regression analysis revealed that lower LCR and higher LCS were independently associated with worse nutritional status, lower handgrip strength, shorter physical performance battery score, and shorter 6‐min walk distance. At 2 years, all‐cause death occurred in 254 patients: 86 (17.6%), 113 (21.5%), and 55 (30.9%) with LCS scores of 0, 1, and 2, respectively (P = 0.001). Cox proportional hazards analysis revealed that LCR and LCS were significantly associated with 2‐year mortality even after adjusting for the conventional risk model (LCS score, 0 vs. 2: hazard ratio, 1.64; 95% confidence interval [CI]; 1.14–2.35; P = 0.007; log‐transformed LCR: hazard ratio, 0.88; 95% CI, 0.81–0.95; P = 0.002). LCR yielded additional prognostic predictability compared with the conventional risk model (continuous net reclassification improvement, 0.153; 95% CI, 0.007–0.299; P = 0.041). Conclusions LCR and LCS emerge as potential predictors of nutritional status, physical function, and prognosis in older patients with HF.
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spelling doaj-art-181e348e6b93457c986cf3814197283f2025-08-20T02:39:04ZengWileyESC Heart Failure2055-58222024-12-011163723373110.1002/ehf2.14972Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosisDaichi Maeda0Yuya Matsue1Nobuyuki Kagiyama2Yudai Fujimoto3Tsutomu Sunayama4Taishi Dotare5Taisuke Nakade6Kentaro Jujo7Kazuya Saito8Kentaro Kamiya9Hiroshi Saito10Yuki Ogasahara11Emi Maekawa12Masaaki Konishi13Takeshi Kitai14Kentaro Iwata15Hiroshi Wada16Masaru Hiki17Takatoshi Kasai18Hirofumi Nagamatsu19Tetsuya Ozawa20Katsuya Izawa21Shuhei Yamamoto22Naoki Aizawa23Kazuki Wakaume24Kazuhiro Oka25Shin‐ichi Momomura26Tohru Minamino27Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiology The Sakakibara Heart Institute of Okayama Okayama JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiology Nishiarai Heart Centre Hospital Tokyo JapanDepartment of Rehabilitation The Sakakibara Heart Institute of Okayama Okayama JapanDepartment of Rehabilitation, School of Allied Health Sciences Kitasato University Sagamihara JapanDepartment of Rehabilitation Kameda Medical Centre Chiba JapanDepartment of Nursing The Sakakibara Heart Institute of Okayama Okayama JapanDepartment of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara JapanDivision of Cardiology Yokohama City University Medical Centre Yokohama JapanDepartment of Cardiovascular Medicine National Cerebral and Cardiovascular Centre Osaka JapanDepartment of Rehabilitation Kobe City Medical Centre General Hospital Kobe‐shi JapanDepartment of Cardiovascular Medicine, Saitama Medical Centre Jichi Medical University Saitama JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanDepartment of Cardiology Tokai University School of Medicine Isehara JapanDepartment of Rehabilitation Odawara Municipal Hospital Odawara JapanDepartment of Rehabilitation Matsui Heart Clinic Saitama JapanDepartment of Rehabilitation Shinshu University Hospital Nagano JapanDepartment of Cardiovascular Medicine, Nephrology and Neurology University of the Ryukyus Okinawa JapanRehabilitation Centre Kitasato University Medical Centre Saitama JapanDepartment of Rehabilitation Saitama Citizens Medical Centre Saitama JapanSaitama Citizens Medical Centre Saitama JapanDepartment of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo JapanAbstract Aims In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional–inflammatory markers and lymphocyte‐to‐C‐reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF. Methods and results This study was a secondary analysis of the FRAGILE‐HF study, a prospective observational study conducted across 15 hospitals in Japan. We included 1212 patients (mean age, 80.2 ± 7.8 years; 513 women) hospitalized with HF, who were classified into three groups according to their LCS score: 0 (n = 498), 1 (n = 533), and 2 (n = 181). Baseline data on physical examination, echocardiography, blood test results (including lymphocyte counts and CRP levels), and oral medication usage were collected in a clinically compensated state before discharge. Nutritional status and physical function were evaluated using several indices and tests. The primary outcome of this study was all‐cause death within 2 years. Univariate and multivariate linear regression analyses were performed to evaluate the associations among the nutritional status, physical function, and LCR/LCS. Patients with an LCS score of 2 were older and had a lower body mass index than those in the other two groups. Multivariate linear regression analysis revealed that lower LCR and higher LCS were independently associated with worse nutritional status, lower handgrip strength, shorter physical performance battery score, and shorter 6‐min walk distance. At 2 years, all‐cause death occurred in 254 patients: 86 (17.6%), 113 (21.5%), and 55 (30.9%) with LCS scores of 0, 1, and 2, respectively (P = 0.001). Cox proportional hazards analysis revealed that LCR and LCS were significantly associated with 2‐year mortality even after adjusting for the conventional risk model (LCS score, 0 vs. 2: hazard ratio, 1.64; 95% confidence interval [CI]; 1.14–2.35; P = 0.007; log‐transformed LCR: hazard ratio, 0.88; 95% CI, 0.81–0.95; P = 0.002). LCR yielded additional prognostic predictability compared with the conventional risk model (continuous net reclassification improvement, 0.153; 95% CI, 0.007–0.299; P = 0.041). Conclusions LCR and LCS emerge as potential predictors of nutritional status, physical function, and prognosis in older patients with HF.https://doi.org/10.1002/ehf2.14972BiomarkersHeart failureInflammationNutritionPhysical function
spellingShingle Daichi Maeda
Yuya Matsue
Nobuyuki Kagiyama
Yudai Fujimoto
Tsutomu Sunayama
Taishi Dotare
Taisuke Nakade
Kentaro Jujo
Kazuya Saito
Kentaro Kamiya
Hiroshi Saito
Yuki Ogasahara
Emi Maekawa
Masaaki Konishi
Takeshi Kitai
Kentaro Iwata
Hiroshi Wada
Masaru Hiki
Takatoshi Kasai
Hirofumi Nagamatsu
Tetsuya Ozawa
Katsuya Izawa
Shuhei Yamamoto
Naoki Aizawa
Kazuki Wakaume
Kazuhiro Oka
Shin‐ichi Momomura
Tohru Minamino
Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
ESC Heart Failure
Biomarkers
Heart failure
Inflammation
Nutrition
Physical function
title Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
title_full Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
title_fullStr Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
title_full_unstemmed Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
title_short Lymphocyte‐to‐C‐reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis
title_sort lymphocyte to c reactive protein ratio and score in patients with heart failure nutritional status physical function and prognosis
topic Biomarkers
Heart failure
Inflammation
Nutrition
Physical function
url https://doi.org/10.1002/ehf2.14972
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