We investigated the relationship between heart failure and malnutrition, inflammation, and thyroid function and evaluated the predictive potential of these markers for major adverse cardiovascular events (MACEs).This study included 454 patients aged over 65 years with heart failure as the main diagnosis for 18 months follow-up. The nutritional and inflammatory status were assessed using the geriatric nutritional risk index (GNRI) and neutrophil-to-lymphocyte ratio (NLR), respectively. Free triiodothyronine (FT3) in thyroid hormone was divided into low, medium, and high FT3. Older patients were divided into two groups according to whether they had endpoint events. Differences in nutrition, inflammation, and thyroid hormone were compared between the two groups. The prognostic value of the combination of GNRI, NLR, and FT3 was analyzed.Older patients in the MACEs (+) group had lower levels of GNRI and FT3 and higher NLR than those in the MACEs (-) group. Low GNRI and FT3 and high NLR were associated with MACEs (P < 0.05). Multivariate Cox regression analysis revealed that low FT3 was an independent predictor of MACEs (P < 0.05). Regardless of how the LVEF changed, when patients had low GNRI and FT3 and high NLR risk factors, the risk of developing MACEs significantly increased. The addition of GNRI, NLR, and FT3 to the basic model significantly increased the predictability of MACEs in patients.Low GNRI and FT3 and high NLR were associated with MACEs. The combination of GNRI, NLR, and FT3 increased the predictive value of MACEs in older patients with heart failure.
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