Global Immune-Nutrition-Inflammation Index for risk stratification of in-hospital mortality in acute heart failure
Öz
Purpose: Acute decompensated heart failure (ADHF) is associated with substantial in-hospital mortality and frequent early rehospitalization. This study evaluated the prognostic value of the Global Immune–Nutrition–Inflammation Index (GINI) in hospitalized patients with ADHF.
Materials and Methods: This retrospective single-center study included 197 consecutive patients hospitalized between January 2023 and December 2025. GINI was calculated from admission laboratory parameters. The primary endpoint was in-hospital all-cause mortality. Secondary endpoints were composites of all-cause mortality or heart failure rehospitalization within 30 and 90 days after discharge.
Results: During hospitalization, 26 patients (13.2%) died. Median admission GINI was higher in non-survivors than in survivors (937.7 [469.3–3118.3] vs. 408.8 [80.6–1592.8]). After multivariable adjustment, GINI was not independently associated with in-hospital mortality (adjusted odds ratio [OR], 1.596; 95% confidence interval [CI], 0.900–2.830), whereas log-transformed troponin remained independently associated with mortality (adjusted OR, 2.910; 95% CI, 1.354–6.252). Among 171 patients discharged alive, the composite endpoint occurred in 52 (30.4%) within 30 days and 106 (62.0%) within 90 days. GINI was not independently associated with either post-discharge endpoint after adjustment for N-terminal pro-B-type natriuretic peptide.
Conclusion: Admission GINI reflected increased risk in unadjusted analyses but did not provide independent prognostic information beyond established clinical and cardiac biomarkers.
Anahtar Kelimeler
Heart failure, Risk stratification., global immune–nutrition–inflammation index, inflammation, prognosis, troponin.
Proje Numarası
Kaynakça
- Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GM, Coats AJ et al. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2022;118:3272-87.
- Pocock SJ, Ariti CA, McMurray JJ, Maggioni A, Køber L, Squire IB et al. Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J. 2013;34:1404-13.
- McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42:3599-726.
- Khanam SS, Choi E, Son JW, Lee JW, Youn YJ, Yoon J et al. Validation of the MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) heart failure risk score and the effect of adding natriuretic peptide for predicting mortality after discharge in hospitalized patients with heart failure. PLoS One 2018;13:e0206380.
- Sager HB, Hulsmans M, Lavine KJ, Moreira MB, Heidt T, Courties G et al. Proliferation and recruitment contribute to myocardial macrophage expansion in chronic heart failure. Circ Res. 2016;119:853-64.
- Murphy SP, Kakkar R, McCarthy CP, Januzzi JL Jr. Inflammation in heart failure: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75:1324-40.
- Qiu J, Huang X, Kuang M, Wang C, Yu C, He S et al. Evaluating the prognostic value of systemic immune-inflammatory index in patients with acute decompensated heart failure. ESC Heart Fail. 2024;11:3133-45.
- Karakurt H, Karakurt ST. The prognostic significance of the novel global immune-nutrition-inflammation index in forecasting in-hospital mortality in patients with ST-elevation myocardial infarction. Catheter Cardiovasc Interv 2026;107:1601-8.
- Feng Z, Yi H, Xiao J, Huang Z, Tu Y, Liu B et al. The global immune-nutrition-inflammation index predicts pathological response and survival in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy. Front Nutr. 2025;12:1717477.
- Topkan E, Kilic Durankus N, Senyurek S, Öztürk D, Besen AA, Mertsoylu H et al. The global immune-nutrition-inflammation index (GINI) as a robust prognostic factor in glioblastoma patients treated with the standard Stupp protocol. Int J Immunopathol Pharmacol. 2024;38:03946320241284089.
