Interleukin-6, infection and cardiovascular outcomes in acute heart failure: Findings from the EDIFICA registry

Autores da FMUP

• Francisco Aguiar Vasques Novoa Faria

  Autor

• João Pedro Melo Marques Pinho Ferreira

  Autor

• António Sousa Barros

  Autor

• Joaquim Adelino Correia Ferreira Leite Moreira

  Autor

• Fernando Miguel Batista Friões

  Autor

Participantes de fora da FMUP

• Marques, P
• Neves, JS
• Vale, C
• Ribeirinho-Soares, P
• Marques, J
• Martins, S
• Guimaraes, JT
• Roncon-Albuquerque, R
• Almeida, J
• Bettencourt, P

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Aims: Interleukin-6 (IL-6) is upregulated in response to infectious and inflammatory triggers and independently predicts all-cause mortality in acute heart failure (AHF). However, the association of IL-6 with cardiovascular outcomes and its interplay with C-reactive protein and infection, a major precipitating factor in AHF, remains poorly understood.Methods and results: The association between IL-6 and clinical outcomes (180 days) in AHF was evaluated using a cohort of 164 patients from the EDIFICA registry. Median IL-6 levels at admission were 17.4 pg/mL. Patients in the higher admission IL-6 tertile presented with lower blood pressure and more congestion, were diagnosed more frequently with infection, and had a longer hospital stay. Higher IL-6 levels were associated with increased risk of HF rehospitalization (hazard ratio per log2 3.69, 95% confidence interval (CI) 1.26-10.8, p =.017) and the composite of HF rehospitalization or cardiovascular death (hazard ratio per log2 3.50; 95% CI 1.28-9.57; p =.014), independently of major AHF prognosticators, including B-type natriuretic peptide and renal function. However, no independent associations were found for all-cause rehospitalization or mortality. Despite a mod-erate correlation of IL-6 with C-reactive protein (CRP) levels (R = .51), the latter were not associated with clinical outcomes in this population.Conclusions: IL-6 levels associate with higher rate of cardiovascular events in AHF, independently of classical prognosticators and evidence of infection, outperforming CRP as an inflammatory outcome biomarker.

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Keywords

• Acute heart failure; Interleukin-6; Inflammation; Infection