Background
Chronic systemic inflammation is associated with an increased risk of HF. We sought
to determine the association between markers of systemic inflammation (interleukin-6
(IL6), interleukin-2 (IL2), tumor necrosis factor-alpha (TNF-a), and c-reactive protein
(CRP)) with HF and its subtypes.
Hypothesis
We hypothesize that inflammatory biomarkers IL6, IL2, TNF-a, and CRP are associated
with HF and its subtypes.
Methods
We included participants in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective
population-based cohort study (2000-2002), without a history of HF and with available
baseline inflammatory biomarkers. We explored the association of IL6, IL2, TNFα, and
CRP with incident HF, HF with reduced ejection fraction (LVEF less than 40%, HFrEF),
HF with mid-range EF (LVEF 40-50%, HFmEF), and HF with preserved ejection fraction
(LVEF more than 50%, HFpEF).
Results
Among 6814 participants, 195 developed HF over 10.9 years (56 HFrEF, 30 HFmrEF, and
57 HFpEF). In the models adjusted for clinical risk factors of heart failure, IL6
(Hazard ratio [HR] 1.33 per doubling; 95% CI: 1.10-1.60), TNFα (HR 2.49 per doubling;
95% CI: 1.18-5.28), and CRP (HR 1.18 per doubling; 95% CI: 1.06 -1.30) were associated
with all HF, IL6 (HR 1.51 per doubling; 95% CI: 1.09-2.10), and CRP (HR 1.21 per doubling;
95% CI: 1.01-1.45) were associated with incident HFpEF, while none of the examined
biomarkers were associated with HFmrEF or HFrEF.
Conclusion
Inflammatory biomarkers (IL6, TNFα, and CRP) are independently associated with incident
HF. IL6 and CRP were associated with incident HFpEF but not HFrEF or HFmrEF. These
findings suggest that activation of the IL6/CRP pathway (as cause, consequence, or
epiphenomenon) may be unique to HFpEF, which may have therapeutic implications.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiac FailureAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Article info
Identification
Copyright
© 2020 Published by Elsevier Inc.
