Abstract 10367: Levels of Oral Inflammation-- not Salivary or Serum Biomarkers-- Predict Worse Functional Status in Hospitalized Patients With Heart Failure

Abstract

Introduction: Serum levels of B-type natriuretic peptide (BNP), C-reactive protein (CRP), interleukin-6 (IL-6) and IL-10 are predictors of poor prognosis in patients with heart failure (HF). These biomarkers are detectable in saliva after myocardial infarction; however, they have not been evaluated in patients with HF. Purpose: To describe correlations and agreement between salivary and serum BNP, CRP, IL-6 and IL-10, and determine whether they predict worse NYHA functional class in patients with HF, after controlling for visible levels of oral inflammation. Methods: In this cross-sectional investigation, serum and whole saliva samples were collected from 75 hospitalized patients with HF [57 ± 12 years, 43% female, NYHA Class I (4%), II (43%), and III (53%)] and analyzed using Biosite Triage (BNP) and a Luminex IS100. Levels of oral inflammation were rated by trained research nurses as good, fair, or poor. Spearman’s rho and the Bland Altman method were used to determine salivary-serum correlations and agreement. Logistic regression was used to determine whether each biomarker was a predictor of worse NYHA functional class, controlling for age, gender, and oral inflammation. Results: Median biomarker concentrations were: BNP [serum 361 pg/mL (25th% = 151, 75th% = 777); saliva 9 (4, 29)], CRP [serum 13 ng/mL (6.9, 29.9); saliva 25.6 (5, 51)], IL-6 [serum 19.3 pg/mL (9.1, 38.6); saliva 10.5 (3.7, 28.2)] and IL-10 [serum 64.1 pg/mL (36.2, 135.5); saliva 4.7 (0.1, 20.3)]. There was a strong correlation for serum-salivary CRP (rs = 0.594, p < .001), moderate correlation for serum-salivary IL-6 (rs = 0.288, p = .037), and no correlations between serum-salivary BNP and IL-10. The Bland Altman test showed good serum-salivary agreement for all biomarkers, but as serum concentrations rose, salivary measures underestimated serum levels. In logistic regressions, none of the biomarkers predicted NYHA functional class, but oral inflammation was a predictor of worse functional class in 6 of 8 regression models. Conclusions: Salivary CRP and IL-6 correlated with serum measures; however, only oral inflammation- not biomarkers- predicted worse functional class. Prospective studies are needed to explore the relationship between oral health and outcomes in patients with HF.