{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:01:58Z","timestamp":1789772518897,"version":"4.0.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sodium\u2013glucose cotransporter 2 inhibitors (SGLT2i) are a cornerstone of treatment for chronic heart failure (CHF), a condition characterised by systemic inflammation and congestion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We investigated the relationship between the neutrophil-to-lymphocyte ratio (NLR), which is thought to reflect both inflammation and congestion, and the clinical characteristics and outcomes of patients with CHF. Additionally, we sought to evaluate the effects of empagliflozin on NLR and across NLR quintiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this post-hoc analysis, we used the EMPEROR-Pooled database, which combines the EMPEROR-Reduced (NCT03057977) and EMPEROR-Preserved (NCT03057951) trials, in which 9706 patients with CHF were randomised to empagliflozin or placebo and had NLR available at baseline. The primary outcome was time to first heart failure hospitalisation or cardiovascular death; secondary endpoints included all-cause mortality and renal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with patients in the lowest NLR quintile, those in the highest quintile were older, more likely to be men, more symptomatic, had higher plasma NT-proBNP and more likely to be treated with loop diuretics. Compared to the lowest NLR quintile, patients in the highest quintile had a greater risk of the primary outcome (14.9% versus 27.3% events; adjusted hazard ratio 1.44 (1.16-1.80); p=0.001), mainly due to more heart failure hospitalisations. Baseline NLR did not modify the effect of empagliflozin on either primary and secondary endpoints. NLR increased during follow-up but this was not affected by empagliflozin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with CHF, a higher NLR was associated with greater congestion and poorer prognosis. The efficacy of empagliflozin was consistent, regardless of baseline NLR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag243","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:18:16Z","timestamp":1789672696000},"source":"Crossref","is-referenced-by-count":0,"title":["Neutrophil-to-Lymphocyte Ratio in Patients With Heart Failure: Findings From The EMPEROR Program"],"prefix":"10.1093","author":[{"given":"Pierpaolo","family":"Pellicori","sequence":"first","affiliation":[{"name":"School of Cardiovascular & Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"RISE-Health, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto , Porto ,","place":["Portugal"]},{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques 1433, CHRU de Nancy, Inserm 1116 and INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-6933","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX"},{"name":"University of Mississippi , Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G F","family":"Cleland","sequence":"additional","affiliation":[{"name":"School of Cardiovascular & Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3926-4225","authenticated-orcid":false,"given":"Pasquale","family":"Maffia","sequence":"additional","affiliation":[{"name":"School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II , Naples ,","place":["Italy"]},{"name":"Africa-Europe CoRE in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance (ARUA) & The Guild of European Research-intensive Universities , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) of German, Heart Center Charit\u00e9, German Centre for Cardiovascular Research (DZHK) Partner Site, Charit\u00e9 Universit\u00e4tsmedizin , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, INSERM, Centre d'Investigations Cliniques 1433, CHRU de Nancy, Inserm 1116 and INI-CRCT (Cardiovascular and Renal Clinical Trialists) F-CRIN Network , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute , Dallas, Texas ,","place":["USA"]},{"name":"Imperial College , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,18]]},"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag243\/71227592\/xvag243.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag243\/71227592\/xvag243.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:15:01Z","timestamp":1789769701000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article\/doi\/10.1093\/eschf\/xvag243\/8817506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/eschf\/xvag243","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"xvag243"}}