Abstract 13565: Long-Term Prognostic Value of the Combination of Systemic Immune-Inflammation Index and AHEAD Score and in Patients Admitted for Acute Decompensated Heart Failure

Backgrounds: Systemic inflammation plays a critical role in the outcomes of heart failure patients. A newly defined index, which is named as systemic immune-inflammation index (SII), had been reported to have prognostic value in patients with cardiovascular disease. On the other hand, comorbidities are strongly associated with poor clinical outcome in heart failure patients (pts). AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score was known to be related to clinical outcomes in acute decompensated heart failure (ADHF) patients. We sought to investigate the prognostic value of the combination of SII and AHEAD in patients admitted for ADHF.

Methods and Results: We studied 263 patients admitted for ADHF and discharged with survival. At the discharge, we obtained SII, which is computed as neutrophils x platelets / lymphocytes, and AHEAD score (range 0-5, atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus). During a follow-up period of 5.0±4.2 yrs, 67 patients had cardiovascular death (CVD). At multivariate Cox analysis, SII and AHEAD score were significantly independently associated with CVD, independently of prior heart failure hospitalization, systolic blood pressure and left ventricular dimension index. The patients with both greater SII (≥571 determined by ROC analysis: AUC 0.632[0.553-0.712]) and AHEAD score (≥3: AUC 0.635[0.562-0.707]) had a significantly increased risk of CVD than those with either and none of them (51% vs 28% vs 16%, p<0.0001, respectively).

Conclusion: The combination of SII and AHEAD score would be useful for stratifying patients at risk for cardiovascular-renal poor outcome in ADHF patients.