Front. Cardiovasc. Med.

Sec. Intensive Care Cardiovascular Medicine

Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1454933

Provisionally accepted

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Objective: Platelet-to-white blood cell ratio (PWR) as a comprehensive indicator of inflammatory response has been widely used to assess the prognosis of various diseases. However, the relationship between PWR and adverse outcomes in patients with acute decompensated heart failure (ADHF) remains unclear. This study aimed to evaluate the association between PWR and all-cause mortality within 30 days of hospitalization in ADHF patients from Jiangxi, China.Methods: A total of 1,453 ADHF patients from the Jiangxi-ADHF study1 cohort were included. The primary outcome measure was all-cause mortality within 30 days of hospitalization. Multivariable Cox proportional hazards regression, restricted cubic spline regression, and receiver operating characteristic curve analysis were employed to explore the association between the inflammatory marker PWR and all-cause mortality in ADHF patients within 30 days of hospitalization.Results: During the 30-day observation period, a total of 53 subjects experienced mortality events. Multivariable Cox regression showed a negative correlation between PWR and all-cause mortality within 30 days of hospitalization in ADHF patients. Restricted cubic spline regression demonstrated an L-shaped association between PWR and 30-day mortality risk (p for nonlinear=0.038). Further threshold analysis revealed a threshold point for PWR at 15.88, where a decrease in PWR below this threshold was significantly associated with increased risk of all-cause mortality (p for log-likelihood ratio test=0.046). Additionally, the results of receiver operating characteristic curve analysis indicated that PWR had high predictive accuracy for mortality events within 30 days of hospitalization in ADHF patients and is significantly better than the traditional HF marker N-Terminal Pro-Brain Natriuretic Peptide (AUC: NT-proBNP 0.69, PWR 0.76; Delong test P

Keywords: platelet-to-white blood cell ratio, short-term prognostic, PWR, Acute decompensated heart failure, ADHF

Received: 27 Jun 2024; Accepted: 28 Jan 2025.

Copyright: © 2025 . This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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