Associations of heart failure and its comorbidities with systemic inflammation response index (SIRI): A cross-sectional, population-based analysis of NHANES 2021-2023

Background Systemic inflammation plays a crucial role in heart failure (HF) and its comorbidities, yet inflammatory markers associated with HF with comorbidities remain inadequately characterized. Objective To identify the associations of systemic inflammation response index (SIRI) with HF with comorbid states, including anemia, cancer, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), diabetes mellitus (DM), hyperlipidemia, hypertension, obesity, and stroke. Method Single- and dual-comorbid states of HF were obtained from the National Health and Nutrition Examination Survey (NHANES) 2021–2023. Prevalence rates and odds ratios of single and dual-comorbid states of HF were calculated for participants with SIRI below and above the median value. Receiver Operating Curve (ROC) analyses were performed to estimate the area under the ROC curve (AUC). Results This study analyzed 7,582 NHANES participants; the median SIRI was 0.94. All comorbid states showed significantly higher prevalence rates and odds ratios for the participants with SIRI above 0.94. In the ROC analysis, all comorbid states showed significant associations with SIRI, including strong associations for HF plus stroke plus cancer (AUC = 0.833; 95% CI = 0.742–0.925), HF plus stroke plus DM (AUC = 0.808; 95% CI = 0.743–0.873), and HF plus stroke plus CAD (AUC = 0.791; 95%CI = 0.707–0.875). Conclusion SIRI is associated with HF with comorbidities. HF comorbid states with strong associations with SIRI include cardiovascular-kidney-metabolic syndrome and cancer.