Selection of Monocyte-To-Lymphocyte Ratio (Mlr) or Lymphocyte-To-Monocyte Ratio (Lmr) As Best Prognostic Tool in Heart Failure: A Systematic Review Publisher

Summary: Can blood-cell ratios predict heart failure outcomes? A review linked MLR and LMR to mortality, but differing studies leave the best clinical cutoff uncertain. #HeartFailure #Biomarkers

Vakhshoori M ; Nemati S ; Sabouhi S ; Tavakol G ; Yavari B ; Shakarami M ; Bondariyan N ; Emami S A ; Shafie D
Source: SN Comprehensive Clinical Medicine Published:2023

Abstract

Inflammatory biomarkers, including monocyte-to-lymphocyte ratio (MLR) and lymphocyte-to-monocyte ratio (LMR), are less investigated for prognosis assessment in heart failure (HF) era. We aimed to assess potential effects of MLR and/or LMR on HF clinical outcomes. English records in PubMed, Scopus, and Web of Science were screened until August 26, 2022. Any records reported clinical outcomes in HF patients including in-hospital or long-term mortality, and extended hospitalization were selected according to pre-defined inclusion and/or exclusion criteria. Five records (three studies on MLR (n = 3321) and two studies on LMR (n = 1002)) were finally chosen. MLR (median, interquartile range (IQR)) ranges from 0.25 (0.18–0.36) to 0.5 (0.4–0.7) and this ratio was significantly associated with in-hospital and long-term death as well as prolonged hospitalization duration. In terms of LMR, median (IQR) was between 2.4 (1.7–3.2) and 2.88 (2.00–4.04). LMR showed remarkable association with long-term mortality. Both MLR and LMR are practical tools for HF prognosis assessment, specifically in countries with limited healthcare resources. However, general consensus is needed to find the best index with its optimal prognostic cut-off point. © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.