Journal of Inflammation Research (Dec 2022)
A Novel Nomogram Integrated with Systemic Inflammation Markers and Traditional Prognostic Factors for Adverse Events’ Prediction in Patients with Chronic Heart Failure in the Southwest of China
Abstract
Zhaojun Liu,1,* Ren Zhang,1,* Yingjie Xv,2 Jinkui Wang,3 Jie Chen,1 Xiaoli Zhou1 1Department of Cardiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Urology, First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Urology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoli Zhou, Email [email protected]: Inflammation contributes to the pathogenesis and progression of heart failure (HF). This study aimed to construct a nomogram based on systemic inflammatory markers and traditional prognostic factors to assess the risk of adverse outcomes (cardiovascular readmission and all-cause death) in patients with chronic heart failure (CHF).Methods: Data were retrospectively collected from patients with HF admitted to the Department of Cardiovascular Medicine at the First Affiliated Hospital of Chongqing Medical University from January 2018 to April 2020, and each patient had complete follow-up information. The follow-up duration was from June 2018 to May 31, 2022. 550 patients were included and randomly assigned to the derivation and validation cohorts with a ratio of 7:3, and prognostic risk factors of CHF were identified by Cox regression analysis. The nomogram chart scoring model was constructed.Results: The Cox multivariate regression analysis showed that traditional prognostic factors such as age (P=0.011), BMI (P=0.048), NYHA classification (P< 0.001), creatinine (P< 0.001), and systemic inflammatory markers including LMR (P=0.001), and PLR (P=0.015) were independent prognostic factors for CHF patients. Integrated with traditional and inflammatory prognostic factors, a nomogram was established, which yielded a C-index value of 0.739 (95% CI: 0.714– 0.764) in the derivation cohort and 0.713 (95% CI: 0.668– 0.758) in the validation cohort, respectively. The calibration curves exhibited good performance of the nomogram in predicting the adverse outcomes for patients with CHF. In subgroups (HFrEF, HFmrEF, and HFpEF groups), the systematic inflammatory markers-based nomograms proved to be effective prediction tools for patients’ adverse overcomes, as well.Conclusion: The nomogram combining systemic inflammatory markers and traditional risk factors has satisfactory predictive performance for adverse outcomes (mortality and readmission) in patients with CHF.Keywords: chronic heart failure, inflammation, prognosis, systemic inflammatory markers, nomogram
