Prognostic Impact of Modified Glasgow Prognostic Score in Patients with Heart Failure with Mildly Reduced 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.