title: Interleukin-1β levels predict long-term mortality and need for heart transplantation in ambulatory patients affected by idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  The prognostic stratification of patients with Idiopathic Dilated Cardiomyopathy (iDCM) is a difficult task. Here, we assessed the additive value of the evaluation of biomarkers of inflammasome activation and systemic inflammation for the long-term risk stratification of iDCM patients.
  
  
  RESULTS
  We studied 156 ambulatory iDCM patients (mean age 58 years, 77% men, 79% in NYHA class 1-2, median Left Ventricular Ejection Fraction (LVEF) 35%, mean sodium 139 mEq/L, median BNP 189 pg/mL, median IL-1 beta (IL-1β) 1.08 pg/mL, median IL-6 1.7 pg/mL and median IL-10 2.7 pg/mL).During the follow-up period of 89.6 months, 35 patients (22%) died/underwent heart transplantation. Patients who died/underwent heart transplantation were more likely to be male, to be in NYHA class III, to have atrial fibrillation, to have lower LVEF and higher BNP levels. IL-1β, IL-6 and IL-10 levels did not differ significantly between the groups of patients with good or bad prognosis. IL-1β levels did not vary significantly among either the different NYHA classes or the quartiles of LVEF. In a multivariable model, however, IL-1β was a strong and independent predictor of all-cause mortality (HR 1.193, 95% CI 1.056 - 1.349, p=0.005 for log squared transformed values). Other factors associated with the outcome were: male gender, presence of atrial fibrillation and sodium concentration. The estimated time-dependent ROC curve of the multivariable model showed an AUC 0.74 (95% CI 0.65-0.86).
  
  
  CONCLUSIONS
  Serum levels of IL-1β could be useful to predict the long-term outcome of patients with iDCM.
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Aneta
authors.initials: A
authors.lastname: Aleksova
authors.affiliation: Department of Medical and Biological Sciences, University of Udine, Italy.
authors.forename: Antonio Paolo
authors.initials: AP
authors.lastname: Beltrami
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Carriere
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Lesizza
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Perrieri-Montanino
authors.affiliation: Department of Medical and Biological Sciences, University of Udine, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Isola
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Gentile
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Salvioni
authors.affiliation: Institute for Maternal and Child Health, IRCCS "Burlo Garofolo" Trieste and University of Trieste, Trieste, Italy.
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Not
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.affiliation: Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
mesh_terms: D000553:Ambulatory Care; D015415:Biomarkers; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006334:Heart Function Tests; D016027:Heart Transplantation; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood*; D008297:Male; D063868:Patient Outcome Assessment; D011379:Prognosis; D012372:ROC Curve; D013997:Time Factors
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta
keywords: brain natriuretic peptide; heart failure; idiopathic dilated cardiomyopathy; interleukin 1 beta; long-term outcome