The additive prognostic value of serial plasma interleukin-6 levels over changes in brain natriuretic peptide in patients with acute heart failure

Markousis-Mavrogenis, G. et al. (2021) The additive prognostic value of serial plasma interleukin-6 levels over changes in brain natriuretic peptide in patients with acute heart failure. Journal of Cardiac Failure, 27(7), pp. 808-811. (doi: 10.1016/j.cardfail.2021.01.008) (PMID:33497808)

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Abstract

Background: Elevated plasma interleukin-6 (IL-6) concentrations are frequently observed in patients with acute heart failure (AHF). However, the predictive value of serial IL-6 measurements beyond brain natriuretic peptide (BNP) remains poorly characterized. Methods and Results: This was a retrospective analysis of the PROTECT cohort (2033 patients with AHF). Plasma IL-6 and BNP levels were determined on days 1, 2, 7 and 14 after admission for AHF in 1591 (78.3%), 1462 (71.9%), 1445 (71.1%) and 1451 (71.4%) patients, respectively. The primary endpoint was 180-day all-cause mortality. The median day-1 IL-6 concentration was 11.1 pg/mL (IQR: 6.6, 20.9) and decreased to 10.1 pg/mL (IQR: 5.6-18.5) at day-7. Higher cross-sectional IL-6 concentrations at all time-points predicted the primary endpoint, independent of a risk model for this cohort and changes in BNP. Each doubling of IL-6 between day-1 and day-7 predicted the primary endpoint independent of baseline IL-6 concentrations, the risk model, baseline BNP and changes in BNP [HR (95% CI): 1.18 (1.07-1.30), p=0.0013]. Collectively, 214 (17%) patients experienced at least a doubling of their IL-6 concentrations between day-1 and day-7. Conclusions: We demonstrate that the temporal evolution patterns of IL-6 in patients with AHF have additive prognostic value independent of changes in BNP.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Markousis-Mavrogenis, G., Tromp, J., Mentz, R. J., O'Connor, C. M., Metra, M., Ponikowski, P., Teerlink, J. R., Cotter, G., Davison, B., Cleland, J. G.F., Givertz, M. M., van Veldhuisen, D. J., Hillege, H. L., Voors, A. A., and van der Meer, P.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Journal of Cardiac Failure
Publisher:Elsevier
ISSN:1071-9164
ISSN (Online):1532-8414
Published Online:23 January 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Journal of Cardiac Failure 27(7): 808-811
Publisher Policy:Reproduced under a Creative Commons License

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