title: Clinical implications of different biomarkers in elderly patients with heart failure.
abstract: OBJECTIVE
  The aim of this article was to determine the importance of neuroendocrine and inflammatory biomarkers in elderly patients (>70 years) with heart failure (HF).
  
  
  METHODS
  In this retrospective and observational study, TNF-α, IL-6, IL-18, Fas (Apo1), BNP, C-reactive protein and cystatin C values were calculated, as well as the relationship between them and the clinical evolution of patients.
  
  
  RESULTS
  A total of 124 patients (mean age ± standard deviation: 83±5 years) were included. After a mean follow-up of 2.4 years, 40.3% of patients were hospitalized for HF and 15.3% of patients died. Those patients who were hospitalized for HF compared with those that did not were hospitalized for HF showed higher values of IL-6 (9.8±13.1 vs 4.65±5.8 pg/ml; p=0.003) and those who died compared with those who are alive higher values of IL-18 (437.1±137.4 vs 299.7±167.2 pg/ml; p=0.01), C-reactive protein (12.6±19.4 vs 6.1±9.4 mg/l; p=0.03), BNP (704.2±428.6 vs 418.5±410.6 pg/ml; p=0.008) and cystatin C (1.76±0.6 vs 1.45±0.5 mg/l; p=0.04). In the multivariate analysis, only IL-18 (hazard ratio: 1.4; 95% CI: 1.05-1.8; p=0.027) remained as an independent predictor for mortality.
  
  
  CONCLUSIONS
  In elderly patients with HF, the determination of biomarkers may be helpful to establish those patients at higher risk.
authors.affiliation: Heart Failure & Vascular Risk Unit, Internal Medicine, University Hospital Ramon y Cajal, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Sanchez
authors.forename: Sergio
authors.initials: S
authors.lastname: Santana
authors.forename: Carlos
authors.initials: C
authors.lastname: Escobar
authors.forename: José Luis
authors.initials: JL
authors.lastname: Santiago
authors.forename: Andrés
authors.initials: A
authors.lastname: Gonzalez
authors.forename: Nuria
authors.initials: N
authors.lastname: Ribas
authors.forename: Javier
authors.initials: J
authors.lastname: Castaño
authors.forename: Luis
authors.initials: L
authors.lastname: Manzano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D055316:Cystatin C / Q000097:blood; D016207:Cytokines / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D020382:Interleukin-18 / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D016207:Cytokines; D020382:Interleukin-18; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein