ObjectiveThis study aimed to explore the association between pan-immune-inflammation value and heart failure outcomes using data from the nationally representative National Health and Nutrition Examination Survey database.MethodsWe conduct a cross-sectional cohort analysis using National Health and Nutrition Examination Survey data, including participants aged ≥20 years with available pan-immune-inflammation value data. We performed smooth curve fitting and threshold analysis, using both linear and non-linear regression models, to assess dose-response relationship and explore the continuous effect of pan-immune-inflammation value on heart failure outcomes.ResultsOur analysis revealed a significant and independent non-linear association between elevated pan-immune-inflammation value levels and an increased risk of heart failure occurrence. After adjustment for multiple covariates, these findings remained consistent and each increment unit in logarithmic pan-immune-inflammation value is associated with 34% increase in the risk of heart failure occurrence. Furthermore, we identified an inflection point of logarithmic pan-immune-inflammation value = 5.98 as a critical threshold. Stratified analyses revealed that the association between pan-immune-inflammation value and heart failure occurrence remains consistent across different subgroups.ConclusionsThis study confirmed the clinical value of pan-immune-inflammation value as a novel inflammatory biomarker in the assessment and monitoring of heart failure.