title: Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic stable heart failure.
abstract: Heart failure is characterized by activation of the immune system which is strongly associated with disease severity and outcome. We sought to compare the prognostic impact of two established inflammatory markers - interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) - in patients with chronic heart failure. In stable, optimally managed outpatients with chronic heart failure, baseline levels of hsCRP and IL-6 were determined. Clinical follow-up was obtained and the rate of events (heart failure related deaths or hospitalizations) were recorded. We included 201 patients (32.7% female, NYHA class II [66.2%] or III [33.8%], mean age 70 years). During a median follow up of 614 (367-761) days, 64 (30.9%) patients experienced an event; those with an event had higher levels of hsCRP (median 2.93 [interquartile range 2.36-8.92] vs 2.23 [1.32-5.77] mmol/l) and IL-6 (7.8 [4.7-10.3] vs 4.3 [2.6-7.9] pg/ml). However, on Cox multivariate analysis, IL-6 but not hsCRP emerged as an independent predictor of prognosis (hazard ratio HR(adjusted) 2.74, 95% confidence interval 1.17-6.43; P = 0.020). Our findings suggest that IL-6 is a better prognostic predictor than hsCRP in patients with chronic stable heart failure.
authors.affiliation: Department of Vascular Diseases, Clinic of Internal Medicine, University Clinical Center Ljubljana, Zaloska 7/VI, Ljubljana SI-1000, Slovenia. borut.jug@gmail.com
authors.forename: Borut
authors.initials: B
authors.lastname: Jug
authors.forename: Barbara Guzic
authors.initials: BG
authors.lastname: Salobir
authors.forename: Nina
authors.initials: N
authors.lastname: Vene
authors.forename: Miran
authors.initials: M
authors.lastname: Sebestjen
authors.forename: Miso
authors.initials: M
authors.lastname: Sabovic
authors.forename: Irena
authors.initials: I
authors.lastname: Keber
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D002097:C-Reactive Protein