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Published on: June 10, 2025
Clinical implications of different biomarkers in elderly patients with heart failure
Irene Sanchez1, Sergio Santana, Carlos Escobar
1Heart Failure & Vascular Risk Unit, Internal Medicine, University Hospital Ramon y Cajal, Madrid, Spain.
Insights
In elderly heart failure patients, elevated interleukin-18 (IL-18) levels predict mortality. Measuring inflammatory and neuroendocrine biomarkers can identify high-risk individuals.
Area of Science:
- Cardiology
- Geriatrics
- Biomarker Research
Background:
- Heart failure (HF) is a significant health concern in elderly populations.
- Neuroendocrine and inflammatory processes play a role in HF pathophysiology.
- Identifying reliable biomarkers for risk stratification in elderly HF patients is crucial.
Purpose of the Study:
- To evaluate the prognostic value of neuroendocrine and inflammatory biomarkers in elderly patients with heart failure.
- To determine the association between specific biomarkers and clinical outcomes, including hospitalization and mortality.
Main Methods:
- Retrospective observational study of 124 elderly patients (>70 years) with heart failure.
- Measurement of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), IL-18, Fas (Apo1), B-type natriuretic peptide (BNP), C-reactive protein, and cystatin C.
- Analysis of biomarker levels in relation to hospitalization for HF and all-cause mortality over a mean follow-up of 2.4 years.
Main Results:
- Patients hospitalized for HF showed higher IL-6 levels (p=0.003).
- Patients who died had significantly higher levels of IL-18 (p=0.01), C-reactive protein (p=0.03), BNP (p=0.008), and cystatin C (p=0.04).
- Multivariate analysis identified IL-18 as an independent predictor of mortality (hazard ratio: 1.4; p=0.027).
Conclusions:
- Biomarker determination is valuable for risk stratification in elderly patients with heart failure.
- Interleukin-18 emerges as a significant independent predictor of mortality in this population.
Aims:
The aim of this article was to determine the importance of neuroendocrine and inflammatory biomarkers in elderly patients (>70 years) with heart failure (HF).
Methods:
In this retrospective and observational study, TNF-α, IL-6, IL-18, Fas (Apo1), BNP, C-reactive protein and cystatin C values were calculated, as well as the relationship between them and the clinical evolution of patients.
Results:
A total of 124 patients (mean age ± standard deviation: 83±5 years) were included. After a mean follow-up of 2.4 years, 40.3% of patients were hospitalized for HF and 15.3% of patients died. Those patients who were hospitalized for HF compared with those that did not were hospitalized for HF showed higher values of IL-6 (9.8±13.1 vs 4.65±5.8 pg/ml; p=0.003) and those who died compared with those who are alive higher values of IL-18 (437.1±137.4 vs 299.7±167.2 pg/ml; p=0.01), C-reactive protein (12.6±19.4 vs 6.1±9.4 mg/l; p=0.03), BNP (704.2±428.6 vs 418.5±410.6 pg/ml; p=0.008) and cystatin C (1.76±0.6 vs 1.45±0.5 mg/l; p=0.04). In the multivariate analysis, only IL-18 (hazard ratio: 1.4; 95% CI: 1.05-1.8; p=0.027) remained as an independent predictor for mortality.
Conclusion:
In elderly patients with HF, the determination of biomarkers may be helpful to establish those patients at higher risk.
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