Clinical implications of different biomarkers in elderly patients with heart failure.

Abstract

The aim of this article was to determine the importance of neuroendocrine and inflammatory biomarkers in elderly patients (>70 years) with heart failure (HF). In this retrospective and observational study, TNF-α, IL-6, IL-18, Fas (Apo1), BNP, C-reactive protein and cystatin C values were calculated, as well as the relationship between them and the clinical evolution of patients. A total of 124 patients (mean age ± standard deviation: 83±5 years) were included. After a mean follow-up of 2.4 years, 40.3% of patients were hospitalized for HF and 15.3% of patients died. Those patients who were hospitalized for HF compared with those that did not were hospitalized for HF showed higher values of IL-6 (9.8±13.1 vs 4.65±5.8 pg/ml; p=0.003) and those who died compared with those who are alive higher values of IL-18 (437.1±137.4 vs 299.7±167.2 pg/ml; p=0.01), C-reactive protein (12.6±19.4 vs 6.1±9.4 mg/l; p=0.03), BNP (704.2±428.6 vs 418.5±410.6 pg/ml; p=0.008) and cystatin C (1.76±0.6 vs 1.45±0.5 mg/l; p=0.04). In the multivariate analysis, only IL-18 (hazard ratio: 1.4; 95% CI: 1.05-1.8; p=0.027) remained as an independent predictor for mortality. In elderly patients with HF, the determination of biomarkers may be helpful to establish those patients at higher risk.