Usefulness of Interleukin-6 and High-sensitivity C-reactive Protein as Prognostic Markers in Outpatients with Heart Failure and Reduced Ejection Fraction

Daniel Agustín Chirino Navarta, Graciela Trejo, Mariela Susana Leonardi, María Pía Fossati, Mirta Gurfinkel, Francisco Tellechea, María Luisa Rodriguez Vazquez, Claudio Dizeo

Abstract


Purpose: The aim of this study was to assess whether interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP)associated with B-type natriuretic peptide (BNP) are independent markers of adverse events in outpatients with heart failureand reduced ejection fraction (HFrEF).Methods: Patients older than 65 years of age with HFrEF who were followed-up on an outpatient basis were prospectivelyincluded. Baseline BNP, IL-6 and hsCRP levels were assessed. Patients with HF after recent myocardial infarction (<6 months),and recent hospitalization (<3 months) due to a condition that could increase inflammatory markers were excluded fromthe analysis. The composite endpoint was all-cause mortality and hospitalization for decompensated heart failure (DHF).Results: A total of 130 patients aged 75 ± 5 years and with EF of 33 ± 11% were included in the study. The composite endpointwas observed in 31.5% (n=41) of patients during a follow-up period of 450 ± 210 days. In the multivariate analysis, elevatedBNP (>442 pg/ml) and elevated IL-6 (>7.2 pg/ml) were independent predictors of the primary endpoint [HR 2.60 (95% CI1.14-5.9), p=0.02 and HR 2.49 (95% CI 1.08-5.7), p=0.03, respectively], but not hsCRP >6.9 mg/l, p=0.2. IL-6 presented anarea under the ROC curve (AUC) of 0.70, BNP 0.73 and hsPCR 0.63, without significant differences between them.Conclusions: BNP and IL-6 were independent markers of the composite endpoint, but not CRP. The discrimination ability ofIL-6 and BNP was moderate.

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