title: Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure.
abstract: OBJECTIVE
  Inflammation is part of the pathophysiology of congestive heart failure (CHF). However, little is known about the impact of the presence of systemic inflammatory disease (SID), defined as inflammatory syndrome with constitutional symptoms and involvement of at least two organs as co-morbidity on the clinical course and prognosis of patients with CHF.
  
  
  RESULTS
  This is an analysis of all 622 patients included in TIME-CHF. After an 18 months follow-up, outcomes of patients with and without SID were compared. Primary endpoint was all-cause hospitalization free survival. Secondary endpoints were overall survival and CHF hospitalization free survival. At baseline, 38 patients had history of SID (6.1%). These patients had higher N-terminal pro brain natriuretic peptide and worse renal function than patients without SID. SID was a risk factor for adverse outcome [primary endpoint: hazard ratio (HR) = 1.73 (95% confidence interval: 1.18-2.55, P = 0.005); survival: HR = 2.60 (1.49-4.55, P = 0.001); CHF hospitalization free survival: HR = 2.3 (1.45-3.65, P < 0.001)]. In multivariate models, SID remained the strongest independent risk factor for survival and CHF hospitalization free survival.
  
  
  CONCLUSIONS
  In elderly patients with CHF, SID is independently accompanied with adverse outcome. Given the increasing prevalence of SID in the elderly population, these findings are clinically important for both risk stratification and patient management.
authors.affiliation: Department of Cardiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. thilo.burkard@usb.ch.
authors.forename: T
authors.initials: T
authors.lastname: Burkard
authors.forename: O
authors.initials: O
authors.lastname: Pfister
authors.forename: H
authors.initials: H
authors.lastname: Rickli
authors.forename: F
authors.initials: F
authors.lastname: Follath
authors.forename: D
authors.initials: D
authors.lastname: Hack
authors.forename: R
authors.initials: R
authors.lastname: Zaker
authors.forename: U
authors.initials: U
authors.lastname: Pittl
authors.forename: R
authors.initials: R
authors.lastname: Handschin
authors.forename: M
authors.initials: M
authors.lastname: Pfisterer
authors.forename: H-P
authors.initials: HP
authors.lastname: Brunner-La Rocca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013557:Switzerland / Q000453:epidemiology