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The Additive Prognostic Value of Serial Plasma Interleukin-6 Levels over Changes in Brain Natriuretic Peptide in

George Markousis-Mavrogenis1, Jasper Tromp2, Robert J Mentz3

  • 1Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Journal of Cardiac Failure
|January 26, 2021
PubMed

Insights

Serial measurements of interleukin-6 (IL-6) in acute heart failure (AHF) patients provide prognostic information beyond brain natriuretic peptide (BNP). Changes in IL-6 levels over time independently predict mortality risk in AHF.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Research

Background:

  • Elevated plasma interleukin-6 (IL-6) is common in acute heart failure (AHF).
  • The prognostic utility of serial IL-6 measurements, independent of brain natriuretic peptide (BNP), is not well understood.

Purpose of the Study:

  • To evaluate the predictive value of serial IL-6 measurements for 180-day all-cause mortality in AHF patients.
  • To determine if IL-6 temporal patterns offer prognostic information beyond BNP levels and established risk models.

Main Methods:

  • Retrospective analysis of the PROTECT cohort (2033 AHF patients).
  • Plasma IL-6 and BNP levels were measured on days 1, 2, 7, and 14 post-admission.
  • Statistical analysis assessed the association between IL-6 concentrations/changes and 180-day mortality, adjusting for covariates.

Main Results:

  • Higher IL-6 levels at all time points predicted 180-day mortality, independent of a risk model and BNP changes.
  • A doubling of IL-6 between day 1 and day 7 independently predicted mortality (HR: 1.18, p=0.0013).
  • This pattern was observed irrespective of baseline IL-6, baseline BNP, and BNP changes.

Conclusions:

  • Temporal changes in IL-6 levels in AHF patients possess prognostic value.
  • IL-6 dynamics provide additive prognostic information that is independent of BNP dynamics.
Abstract

Keywords:
BNPIL-6NT-proBNPSerialchangelandmark

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