Burak KARDEŞLER, Fikriye KALKAN
Archives of Basic and Clinical Research - 2026;8(2):106-111
Objective: Eosinophil-derived hematological indices have been proposed as potential prognostic markers for cardiovascular disease; however, their clinical value in acute decompensated heart failure (ADHF) remains unclear. This study aimed to comprehensively evaluate the prognostic significance of eosinophil-based hematological indices, particularly the neutrophil-to-eosinophil ratio (NER), in hospitalized patients with ADHF. Methods: This single-center, retrospective observational study included 245 consecutive adult patients hospitalized for ADHF between January 2023 and January 2024. Patients with conditions known to influence eosinophil counts, including allergic diseases, recent systemic corticosteroid use, active infection, malignancy, chronic inflammatory disorders, end-stage renal failure, and severe liver disease, were excluded. Hematological indices calculated from blood samples obtained within the first 24 h of admission included NER, eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-monocyte ratio (EMR), eosinophil percentage, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII). The primary outcome was all-cause mortality during the one-year follow-up period. Results: During the follow-up period, 93 (38.0%) patients died. Non-survivors were significantly older and exhibited a higher inflammatory burden, with increased C-reactive protein levels, NLR, and SII values. Eosinophil counts, eosinophil percentages, and EMR values were significantly lower in non-survivors, whereas the NER and ELR did not differ between the groups. Receiver operating characteristic analysis demonstrated poor discriminative performance for eosinophil-derived indices, with area under the curve values of <= 0.55. In the multivariate logistic regression analysis, only age was an independent predictor of mortality. Conclusion: Eosinophil-based hematological indices have limited prognostic value for mortality in patients hospitalized with ADHF. Although eosinophil suppression is associated with adverse outcomes, these indices do not provide independent prognostic information beyond age.
