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Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic
Borut Jug1, Barbara Guzic Salobir, Nina Vene
1Department of Vascular Diseases, Clinic of Internal Medicine, University Clinical Center Ljubljana, Zaloska 7/VI, Ljubljana SI-1000, Slovenia. borut.jug@gmail.com
Insights
Interleukin-6 (IL-6) better predicts outcomes in chronic heart failure patients than high-sensitivity C-reactive protein (hsCRP). IL-6 levels indicate a higher risk of heart failure events, informing prognosis.
Area of Science:
- Cardiology
- Immunology
- Biomarker Research
Background:
- Immune system activation is linked to heart failure severity and prognosis.
- Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are established inflammatory markers.
- Prognostic value of these markers in chronic heart failure requires further comparison.
Purpose of the Study:
- To compare the prognostic impact of IL-6 and hsCRP in stable chronic heart failure patients.
- To determine which inflammatory marker, IL-6 or hsCRP, is a superior predictor of adverse events.
Main Methods:
- Prospective study of 201 stable outpatients with chronic heart failure.
- Baseline measurement of serum IL-6 and hsCRP levels.
- Clinical follow-up to record heart failure-related deaths or hospitalizations.
Main Results:
- Patients experiencing events had higher baseline hsCRP and IL-6 levels.
- Cox multivariate analysis identified IL-6 as an independent predictor of prognosis (aHR 2.74, P=0.020).
- hsCRP did not emerge as an independent predictor in the multivariate analysis.
Conclusions:
- IL-6 is a more effective prognostic marker than hsCRP in chronic stable heart failure.
- IL-6 levels can aid in risk stratification and management of heart failure patients.
- Further research into immune markers for heart failure prognosis is warranted.
Abstract:
Heart failure is characterized by activation of the immune system which is strongly associated with disease severity and outcome. We sought to compare the prognostic impact of two established inflammatory markers - interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) - in patients with chronic heart failure. In stable, optimally managed outpatients with chronic heart failure, baseline levels of hsCRP and IL-6 were determined. Clinical follow-up was obtained and the rate of events (heart failure related deaths or hospitalizations) were recorded. We included 201 patients (32.7% female, NYHA class II [66.2%] or III [33.8%], mean age 70 years). During a median follow up of 614 (367-761) days, 64 (30.9%) patients experienced an event; those with an event had higher levels of hsCRP (median 2.93 [interquartile range 2.36-8.92] vs 2.23 [1.32-5.77] mmol/l) and IL-6 (7.8 [4.7-10.3] vs 4.3 [2.6-7.9] pg/ml). However, on Cox multivariate analysis, IL-6 but not hsCRP emerged as an independent predictor of prognosis (hazard ratio HR(adjusted) 2.74, 95% confidence interval 1.17-6.43; P = 0.020). Our findings suggest that IL-6 is a better prognostic predictor than hsCRP in patients with chronic stable heart failure.
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