Tahir Bezgin1, Aziz İnan Çelik1, Ali Karagöz2, Nart Zafer Baytuğan1, Metin Çağdaş1, Süleyman Karakoyun3, Cihangir Kaymaz2

1Clinic of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey
2Clinic of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, İstanbul, Turkey
3 Clinic of Cardiology, Akademi Hospital, Kocaeli, Turkey

Keywords: Heart failure; ejection fraction


Introduction: Inflammation and malnutrition may trigger heart failure development and progression (HF). However, the relationship of the modified Glasgow prognostic score (mGPS), which is derived from C-reactive protein and albumin with mildly reduced ejection fraction HF (HFmrEF), is not well-known. We aimed to determine whether the modified Glasgow prognostic score (mGPS) is helpful for the prediction of all-cause mortality in patients with HFmrEF.

Patients and Methods: Patients with HFmrEF admitted to our outpatient clinic between January 2016 and January 2020 were enrolled. All-cause mortality was defined as the primary endpoint. The mGPS was calculated and, its association with overall survival was determined.

Results: Data were analyzed for 259 patients. The mGPS≤ 1 in 172 (66%), and 2 in 87 (34%) patients, respectively. Higher mGPS was related to worse results of routine biomarkers associated with prognosis, especially NT-proBNP [777 (112-4564) pg/mL vs. 350 (65-3521) pg/mL, respectively, p< 0.0001)]. In multivariable Cox model, NT-proBNP [1.83 (1.32-2.55), p< 0.0001], mGPS 2 vs. ≤1 [2.43 (1.2-4.93), p= 0.013], and coronary artery disease (CAD) [3.15 (1.46-6.82), p= 0.003] were found to be independently associated with all-cause mortality.

Conclusion: The immune-nutritional score mGPS predicts mortality during long-term follow-up of patients with HFmrEF. The mGPS might be used for risk status assessment of HFmrEF.

Ethics Committee Approval

The approval for this study was obtained from Kocaeli Derince Training and Research Hospital Clinical Research Ethics Committee (Decision no: 2021-92, Date: 09.09.2021).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - TB, AK, MÇ; Analysis/Interpretation - TB, AİÇ, AK; Data Collection - FB, MÇ, NZB; Writing - FB, SK; Critical Revision - NZB, CK; Final Approval - CK, AİÇ, SK; Statistical Analysis - AK, MÇ; Overall Responsibility - FB.

Conflict of Interest

The authors declared that there was no conflict of interest during the preparation and publication of this article.

Financial Disclosure

The authors declared that this study has received no financial support.