Neutrophil-Lymphocyte Ratio and High Sensitivity C-Reactive Protein as Markers of Heart Failure Severity: A Study at the University of Port-Harcourt Teaching Hospital Heart Failure Clinic

Systemic inflammatory markers, such as the Neutrophil-Lymphocyte Ratio (NLR) and high-sensitivity Creactive protein (hs-CRP), have been linked to cardiovascular diseases, including heart failure (HF), and increased mortality rates. This study aimed to assess NLR and hs-CRP levels in chronic HF patie...

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Bibliographic Details
Published in:	West African journal of medicine Vol. 41; no. 5; p. 562
Main Authors:	Ajala, A O, Dodiyi-Manuel, Sotonye, Oyan, Boma, Ejituwu, Jacquelin, Akpa, Maclean
Format:	Journal Article
Language:	English
Published:	Nigeria 31-05-2024
Subjects:	Adult Aged Biomarkers - blood C-Reactive Protein - analysis Cross-Sectional Studies Echocardiography - methods Female Heart Failure - blood Heart Failure - diagnosis Hospitals, Teaching Humans Lymphocytes Male Middle Aged Natriuretic Peptide, Brain - blood Neutrophils Peptide Fragments - blood Severity of Illness Index South Africa South Africa Heart failure Chronic Inflammatory markers Neutrophillymphocyte ratio hs-CRP
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Summary:	Systemic inflammatory markers, such as the Neutrophil-Lymphocyte Ratio (NLR) and high-sensitivity Creactive protein (hs-CRP), have been linked to cardiovascular diseases, including heart failure (HF), and increased mortality rates. This study aimed to assess NLR and hs-CRP levels in chronic HF patients and determine the relationship between these markers with HF severity. A descriptive cross-sectional study was conducted on 136 chronic HF patients at the University of Port-Harcourt Teaching Hospital. Informed consent was obtained, and participants completed a questionnaire. Blood samples were collected for a complete blood count, hs-CRP, and N Terminal-pro-Brain Natriuretic Peptide measurements. Echocardiography was performed for all study participants. The mean age was 59 years and 51.5% were males. Among the participants, 27(19.9%) had an NLR >2, while 91(66.9%) had elevated hs-CRP levels. There was a non-significant positive correlation between NLR and CRP values (r=0.131, p=0.128). Elevated hs-CRP levels were found in 67.1% and 66.7% of patients with left ventricular systolic and diastolic dysfunction, respectively. However, elevated NLR >2 was found in only 21.5% and 17.6% of these patients respectively. Highly sensitive-CRP significantly correlated with NT-Pro-BNP (0.410<0.0001) but not with NYHA classification, Ejection Fraction, and Anemia. Highly sensitive CRP was a more reliable inflammation marker in HF patients than NLR. High hs-CRP levels could predict rising NT-Pro-BNP and were associated with left ventricular systolic dysfunction than NLR. The Neutrophil Lymphocyte ratio, while cheap and accessible in the study environment, was unable to predict worsening HF possibly due to typically lower NLR values in blacks.
ISSN:	0189-160X