Abstract
BACKGROUND: Heart failure (HF) represents the terminal phase of cardiovascular disease and is the primary cause of mortality in elderly patients diagnosed with HF. Precise early prediction of HF onset and progression is crucial for enhancing survival rates in patients. Central to HF's pathophysiology is inflammation, with the monocyte-lymphocyte ratio (MLR) emerging as a potential novel inflammatory marker. The relationship between MLR and HF in the elderly is not well-defined. Therefore, this study, utilizing the 2016-2019 Sichuan Zigong Heart Failure Database, aimed to explore the correlation between MLR levels and 3-month mortality in elderly HF patients within the Chinese population. METHODS: A retrospective cohort study was conducted using the 2016-2019 Heart Failure Database from Zigong City, Sichuan Province, China. HF was identified based on the diagnostic criteria of the European Society of Cardiology. The MLR was calculated as monocyte count divided by lymphocyte count. Both lymphocyte and monocyte counts were sourced directly from laboratory datasets. Cox regression analysis was performed to assess the relationship between MLR and 3-month mortality, with stratified evaluations conducted based on age, gender, and comorbidity index. RESULTS: Of the 1,448 elderly HF patients assessed, multivariate regression analyses revealed that the high-level MLR group had a heightened occurrence of 3-month mortalities, presenting a hazard ratio (HR) and a 95% CI of 3.31 (1.42-7.7). In the subgroup analyses, the effect sizes of MLR remained consistent across all subgroups (all P-values > 0.05). CONCLUSION: MLR is significantly associated with 3-month mortality rates in elderly HF patients. Early MLR evaluations might offer a pathway to augment the life quality and survival outcomes of these patients.