© 2008 European Society of Cardiology
Prognostic role of pro- and anti-inflammatory cytokines and their polymorphisms in acute decompensated heart failure
a Department of Medicine, Kuopio University Hospital Kuopio, Finland
b Department of Medicine, Helsinki University Hospital Helsinki, Finland
c Department of Medicine, Jyväskylä Central Hospital Jyväskylä, Finland
d Department of Clinical Chemistry, Kuopio University Hospital Kuopio, Finland
* Corresponding author. Department of Medicine, Kuopio University Hospital, P.O. Box 1777, Puijonlaaksontie 2, FI-70210 Kuopio, Finland. Tel.: +358 17 173422; fax: +358 17 173959. E-mail address: kati.h.miettinen{at}kuh.fi (K.H. Miettinen).
| Abstract |
|---|
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-
), 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-
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-
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-
, 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.
Key Words: Acute heart failure Cytokines Prognosis
Received April 5, 2007; Revised November 13, 2007; Accepted February 7, 2008
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
A. T. Yan, R. T. Yan, M. Cushman, A. Redheuil, R. P. Tracy, D. K. Arnett, B. D. Rosen, R. L. McClelland, D. A. Bluemke, and J. A.C. Lima Relationship of interleukin-6 with regional and global left-ventricular function in asymptomatic individuals without clinical cardiovascular disease: insights from the Multi-Ethnic Study of Atherosclerosis Eur. Heart J., January 10, 2010; (2010) ehp454v1. [Abstract] [Full Text] [PDF] |
||||
