To explore the predictive value of peripheral blood uric acid (UA)/creatinine (Cr) ratio, neutrophil/lymphocyte ratio (NLR), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in acute heart failure (AHF) during the perioperative period of lung cancer patients.

A retrospective cohort study was conducted on 186 patients who underwent surgical treatment for lung cancer from January 2022 to December 2024, including 113 males and 73 females; the age ranged from 41 to 78 years, with an average of (61.19±8.41) years. According to whether patients experienced AHF during the perioperative period, they were divided into AHF group (31 cases) and non AHF group (155 cases). The clinical baseline data of the two groups were compared, and multiple regression analysis was used to analyze the influencing factors of AHF in lung cancer patients during the perioperative period, the receiver operating characteristic (ROC) curve was applied to analyze the predictive value of each factor for AHF in lung cancer patients during the perioperative period.

There were significant differences in pathological stage, NYHA cardiac function grade, UA/Cr, NLR and NT-proBNP between two groups (P<0.05). Multivariate regression analysis showed that blood UA/Cr, NLR and NT-proBNP were all risk factors for perioperative AHF in lung cancer patients (P<0.05). ROC curve analysis showed that the cutoff value of serum UA/Cr in diagnosing perioperative AHF was 16.69, AUC was 0.829 (95%CI0.749-0.909), sensitivity was 74.20%, and specificity was 78.70%. The cut-off value of NLR was 2.205, AUC was 0.856 (95%CI: 0.777-0.935), sensitivity was 90.30%, and specificity was 66.50%. The cut-off value of NT-proBNP was 2 099.495 ng/L, the area under the working characteristic curve (AUC) of the subjects was 0.903 (95%CI: 0.833-0.972), with a sensitivity of 71.00% and a specificity of 98.70%; The combined diagnostic AUC was 0.986 (95%CI: 0.970-1.000), with a sensitivity of 96.80% and a specificity of 94.80%.

The combined diagnosis of peripheral blood UA/Cr ratio, NLR and NT-proBNP has a certain predictive value for perioperative AHF in lung cancer patients, with high sensitivity and specificity.