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Prognostic role of pro‐ and anti‐inflammatory cytokines and their polymorphisms in acute decompensated heart failure
Author(s) -
Miettinen Kati H.,
Lassus Johan,
Harjola VeliPekka,
SiiriläWaris Krista,
Melin John,
Punn Kari R.,
Nieminen Markku S.,
Laakso Markku,
Peuhkurinen Keijo J.
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.02.008
Subject(s) - medicine , acute decompensated heart failure , heart failure , natriuretic peptide , cytokine , tumor necrosis factor alpha , proinflammatory cytokine , multivariate analysis , interleukin 6 , inflammation , immunology , cardiology , gastroenterology
Background: Cytokines play an important role in chronic heart failure (HF), but little is known about their involvement in acute decompensated heart failure (ADHF). Aim: To evaluate the prognostic role of inflammatory cytokines in patients with ADHF. Methods: Levels of interleukin (IL)‐6, tumour necrosis factor alpha (TNF‐α), IL‐10 and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) were measured in 423 patients with ADHF. In addition, appropriate cytokine gene polymorphisms were determined. Survival was followed up to 12 months, and prognostic factors were evaluated. Results: Elevated levels of IL‐6 and TNF‐α were strongly associated with increased 12‐month mortality ( P < 0.001 for both), whereas the level of IL‐10 was predictive only of 6‐month mortality ( P < 0.01). In multivariate analysis IL‐6, chronic renal insufficiency, NT‐proBNP, age/10 years' increase and TNF‐α were identified as the most powerful predictors of 12‐month mortality. Furthermore, high levels of both IL‐6 and NT‐proBNP were associated with >7‐fold mortality. Cytokine gene polymorphisms were not associated with outcome. Conclusions: Circulating levels of pro‐inflammatory cytokines IL‐6 and TNF‐α, and the level of an anti‐inflammatory cytokine IL‐10, but not their gene polymorphisms, provide novel and important prognostic information in patients with ADHF. Combining measurements of pro‐inflammatory cytokines and NT‐proBNP seems a promising tool in the prognostic assessment of these patients.