Prevalence and Predictors of High Inflammatory Risk in Heart Failure Subtypes: Findings From the Global POSEIDON...

Area of Science:

• Cardiology
• Inflammation Research
• Public Health

Background:

• Inflammation plays a key role in heart failure (HF) pathophysiology.
• The global prevalence of elevated high-sensitivity C-reactive protein (hsCRP) in HF patients across the ejection fraction (EF) spectrum is not well understood.

Purpose of the Study:

• To determine the prevalence of high inflammatory risk (hsCRP ≥2 mg/L) in a global real-world HF cohort.
• To identify clinical correlates of elevated hsCRP across HF subtypes (HFpEF, HFmrEF, HFrEF).

Main Methods:

• Prospective enrollment of 18,904 individuals across 18 countries.
• Analysis of 11,809 HF patients with available hsCRP, excluding recent infections.
• Characterization of elevated hsCRP prevalence and associated clinical factors.

Main Results:

• Elevated hsCRP (≥2 mg/L) was observed in 38.8% of HFpEF, 38.1% of HFmrEF, and 38.2% of HFrEF patients.
• Patients with elevated hsCRP were more likely to be female, have chronic kidney disease, obesity, worse functional class, and higher NT-proBNP.
• Independent predictors included smoking, autoimmune disease, obesity, reduced eGFR, dyslipidemia, and worse NYHA class, consistent across HF subtypes.

Conclusions:

• Approximately 4 in 10 patients in a global HF population exhibit high inflammatory risk.
• High inflammatory risk is associated with more severe HF and a cardio-kidney-metabolic phenotype.
• Findings were consistent across HF subtypes, highlighting a common inflammatory burden.