Heart failure risk closely associated with hs-CRP, HDL-C and lymphocyte count: Study

A new study published in the journal of BMC Cardiovascular Disorder showed that heart failure risk was linked to both the high-sensitivity C-reactive protein to HDL-C ratio (HCHR) and the high-sensitivity C-reactive protein to lymphocyte count ratio (HCLR).

As demonstrated objectively by elevated natriuretic peptide levels and/or congestion of the pulmonary or systemic circulation, heart failure (HF) is a group of syndromes with symptoms and/or indicators brought on by anatomical and/or functional abnormalities of the heart. A growing body of data suggests that inflammation has a major role in the development and progression of heart failure.

High-sensitivity C-reactive protein (hs-CRP) which is a marker for inflammation is mostly produced by the liver and serves as a protein linked to acute systemic inflammation. Chronic inflammation is associated with heart failure, and two new inflammatory markers are the high-sensitivity C-reactive protein to HDL-C ratio and the high-sensitivity C-reactive protein to lymphocyte count ratio. This study assessed the relationship between HF, HCHR, and HCLR.

This research used the National Health and Nutrition Examination Survey (NHANES, 2015–2018) to conduct a cross-sectional study. They employed threshold effect analysis, smoothed curve fitting, and subgroup analyses of the underlying demographic factors to look into possible effects after using multivariate logistic regression to find the relationship between HCLR, HCHR, and HF. The relationship between each index and HF was investigated using the receiver operating characteristic curves.

Multivariate logistic regression after Ln conversion for HCHR and HCLR revealed that, in the fully adjusted model 3, subjects in the highest tertile of Ln(HCHR) had a significantly higher risk of 45% than those in the lowest tertile, while participants in the highest tertile of Ln had a significantly higher risk of 52% than the patients in the lowest tertile.

This study comprised a total of 8751 subjects where Ln(HCHR) and HF showed a nonlinear connection with a log-likelihood ratio of 0.024 and an inflection point of -2.71. No major associations between Ln(HCHR), Ln(HCLR), and particular subgroups were found by subgroup analysis. Ln(HCLR) has the highest diagnostic effectiveness for HF, followed by Ln(HCHR), according to the ROC curve. Overall, the prevalence of HF in US adults is positively correlated with Ln(HCHR) and Ln(HCLR). In particular, there was a nonlinear relationship between Ln(HCHR) levels and HF, with an inflection point at -2.71.

Source:

Zhang, P., Mo, D., Lin, F., & Dai, H. (2025). Relationship between novel inflammatory markers derived from high-sensitivity C-reactive protein and heart failure: a cross-sectional study. BMC Cardiovascular Disorders, 25(1). https://doi.org/10.1186/s12872-025-04558-2