Prognostic value of the inflammatory burden index in predicting 1-year mortality in patients undergoing cardiac resynchronization therapy for heart failure

@article{yilmaz2026prognostic,
  title = {{Prognostic value of the inflammatory burden index in predicting 1-year mortality in patients undergoing cardiac resynchronization therapy for heart failure}},
  author = {Rustem Yilmaz and Kenan Toprak and Ahmet Karagoz and Osman Can Yontar and Mustafa Yolcu and Yasar Turan and Faruk Boyaci and Okan Oguzhan Ovaz and Emre Kasim Yilmaz and Enes Furkan Ozturk and Ersoy Öz},
  journal = {Frontiers in cardiovascular medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1934817},
  url = {https://europepmc.org/article/PMC/PMC13690696},
  note = {CC BY},
}

TY  - JOUR
TI  - Prognostic value of the inflammatory burden index in predicting 1-year mortality in patients undergoing cardiac resynchronization therapy for heart failure
AU  - Rustem Yilmaz
AU  - Kenan Toprak
AU  - Ahmet Karagoz
AU  - Osman Can Yontar
AU  - Mustafa Yolcu
AU  - Yasar Turan
AU  - Faruk Boyaci
AU  - Okan Oguzhan Ovaz
AU  - Emre Kasim Yilmaz
AU  - Enes Furkan Ozturk
AU  - Ersoy Öz
PY  - 2026
DA  - 2026/10/09
JO  - Frontiers in cardiovascular medicine
DO  - 10.3389/fcvm.2026.1934817
UR  - https://europepmc.org/article/PMC/PMC13690696
AB  - Background/objectives: Heart failure (HF) is one of the leading causes of death and impairs quality of life worldwide. Systemic inflammation has been increasingly recognized as a major contributor to adverse outcomes in patients with heart failure. The Inflammatory Burden Index (IBI), a composite marker integrating C-reactive protein (CRP), neutrophils, and lymphocytes, may offer improved prognostic value over traditional inflammatory markers. This study aimed to evaluate the prognostic significance of IBI in predicting one-year mortality among patients undergoing Cardiac Resynchronization Therapy (CRT).  Methods: This retrospective observational study included 525 heart failure patients who received CRT between January 2020 and January 2024. Patients were grouped based on 1-year survival status. Continuous variables were compared using Student's t-test or Mann–Whitney U test based on normality assessment, and presented as mean ± SD or median [interquartile range, IQR]. To handle right-skewness and ensure linearity in the logit, inflammatory markers were logarithmically transformed [Log(IBI) and Log(CRP)]. Multivariable logistic regression models were constructed using a standardized baseline clinical model. Incremental prognostic value was evaluated using Integrated Discrimination Improvement (IDI), continuous Net Reclassification Improvement (NRI), and DeLong's test.  Results: Baseline CRP (median [IQR]: 20.90 [11.95–33.00] vs. 6.56 [3.37–13.80] mg/dL, p < 0.001) and IBI (median [IQR]: 81.15 [36.56–230.90] vs. 18.61 [7.76–44.46], p < 0.001) were significantly higher in non-survivors. In multivariable analysis, both Log(IBI) (OR: 1.983; 95% CI: 1.463–2.687; p < 0.001) and Log(CRP) (OR: 3.265; 95% CI: 2.278–4.678; p < 0.001) independently predicted 1-year mortality. Incorporating Log(IBI) or Log(CRP) significantly improved model discrimination over baseline clinical risk (AUC increased from 0.684 to 0.778 and 0.795, respectively; DeLong p < 0.001), yielding substantial IDI (0.0953 and 0.1118, p < 0.001) and continuous NRI (67.1% and 80.6%, p < 0.001) gains. Head-to-head comparison showed comparable discriminative performance between Log(IBI) and Log(CRP) models (DeLong p = 0.307).  Conclusions: Both Log(IBI) and Log(CRP) are independent predictors of 1-year mortality in HF patients undergoing CRT, offering comparable incremental prognostic utility over standard clinical risk factors. Incorporating these inflammatory biomarkers into routine risk stratification may refine the identification of high-risk candidates.
SN  - 2297-055X
ER  -