Evaluation of Triglyceride/High Density Lipoprotein Ratio as a Diagnostic and Prognostic Marker for Reduced Ejection Fraction Heart Failure in Comparison to Brain-Natriuretic Peptide

Background: heart failure is a condition that heart cannot pump blood in efficient way and this result in building up fluid and a reduced supply of oxygen to organs. Also, it can result from conditions like heart disease, hypertension, or diabetes. Brain natriuretic peptide (BNP) can be used in the diagnosis and evaluation of heart failure severity. The triglycerides-to-HDL ratio is a key marker of cardiovascular risk in heart failure, reflecting insulin resistance and metabolic health. A high ratio is associated with worse outcomes, including increased inflammation and arterial stiffness. Objectives: To evaluate the diagnostic and prognostic value of Triglyceride to HDL ratio for reduced ejection fraction heart failure in comparison with brain-natriuretic peptide. Methods: A case-control study was carried out between October 2024 and March 2025 at an internal medicine specialist in Al-Najaf, Iraq. There were 180 participants, 90 as control group and 90 as heart failure patients. The information gathered comprised height, weight, age, gender, brain natriuretic peptide (BNP), triglyceride (TG) and high-density lipoprotein (HDL). Results: The results showed that when comparing BMI, age, and gender between cases and control groups there was no significant difference (P > 0.05). While, there was a significant variation in the levels of BNP and TG/HDL ratio between them (P < 0.000). According to the results, the sensitivity and specificity of BNP and TGL/HDL ratio as diagnostic & predictive markers were approximate. Additionally, a positive & significant correlation between TG/HDL ratio and inflammatory marker C-reactive protein was observed. Conclusion: BNP and TG/HDL ratio are significant factors that play an important role in heart failure, TG/HDL ratio can be used as a diagnostic and predictive marker in heart failure reflect association between dyslipidemia, inflammation, and heart failure.