Background. While myocardial damage in heart failure (HF) patients with reduced ejection fraction (HFrEF) has been shown to be driven by oxidative stress, inflammation is a recognized factor in disease progression in both HFrEF and HF with preserved ejection fraction (HFpEF). Inflammation is presented as regulated by platelet-induced activation of blood leukocytes. Neutrophils take part in maintaining of pro-inflammatory state in HF. Hypercholesterolemia is stated to heighten neutrophil production, which contributes to accelerated cardiovascular inflammation. HF pathogenesis differences in the different HF phenotypes remain to be investigated.

Aim: to determine differences in complete blood count, C-reactive protein (CRP) concentration, lipidogram and clinical readings between chronic HF (CHF) without previous myocardial infarction (MI) groups according to EF and between HFrEF groups according to MI presence in CHF development history and correlations between these readings.

Methods. Four groups of patients (n = 266) were analyzed. 208 patients diagnosed with CHF who had had no documented history of previous MI were separated into two groups according to left ventricular ejection fraction (LVEF): LVEF ≥ 50%, n = 117; LVEF < 50%, n = 91. Additionally, 149 HFrEF patients were separated into two additional groups: those who had had no MI (n = 91) and those with MI (n = 58). Laboratory and clinical readings were taken from the patients’ medical histories.

Results. MCHC was lower and RDW-CV was higher in the lower EF group without a history of MI (337.32 (10.60) and 331.46 (13.13), p=0.004; 13.6 (11.5-16.9) and 14.7 (12.6-19.1), p=0.001). Lymphocyte percentage and lymphocyte-to-monocyte ratio (LYM/MON) were lower in the lower EF group without a history of MI (30.48 (10.87), 26.98 (9.08), p=0.045; 3.33 (1.22-9.33), 3 (0.44-6.5), p=0.011). CRP concentration (6.9 (1.46-62.97), 7 (1-33.99), p=0.012) was higher in HFrEF with MI in comparison with the group without MI. Neutrophil count correlated with PLT (r_s=0.278, p=0.001) and weight (r_p=0.196, p=0.024). Lymphocyte count correlated with PLT and RDW-CV (r_s=0.200, p=0.018; r_s=-0.223; p=0.032) and body mass index (r_p=0.186, p=0.032). RDW-CV and monocyte count correlated with NT-proBNP and serum creatinine (r_s=0.358, p=0.034; r_s=0.424, p<0.001 and r_s=0.354, p=0.012; r_s=0.205, p=0.018 respectively). Total cholesterol concentration correlated with LYM/MON, monocyte percentage, lymphocyte percentage and count (r_s=0.534, p<0.001; r_s=-0.312, p=0.029; r_s=0.355, p=0.012; r_s=0.397, p=0.004 respectively). EF correlated with MCHC and RDW-CV (r_s=0.273, p=0.001; r_s=-0.404, p<0.001). Total cholesterol concentration correlated with LYM/MON (r_s=0.534, p<0.001). HDL cholesterol concentration was lower in the HFrEF with MI group (0.96 (0.44-2.2); 0.92 (0.56-1.97, p=0.010). Uric acid concentration correlated with platelet-to-lymphocyte and lymphocyte-to-monocyte ratio (r_s=0.321, p=0.032; r_s=-0.341, p=0.023). Creatinine concentration correlated with monocyte percentage and count (r_p=0.312, p=0.001; r_p=0.287, p=0.003).

Conclusion: 1) MCHC and lymphocyte percentage were lower and RDW-CV was higher in the HFrEF group without MI; CRP concentration was higher in HFrEF with MI in comparison with the group without MI; 2) HDL cholesterol concentration was lower and CRP concentration was higher in the HFrEF group with MI in comparison with the group without MI; total cholesterol concentration correlated with LYM/MON; 3) monocyte, lymphocyte count and their ratio correlated with patients’ condition reflected readings NT-proBNP, serum creatinine, uric acid concentrations.