Abstract
Introduction: Inflammation is a fundamental phenomenon in heart failure, but the prognostic or therapeutic role of markers such as interleukin-6 (IL-6) has not yet been clarified. The objective of this study is to describe the clinical profile of patients with elevated IL-6 and determine if they have worse clinical outcomes. Methods: A retrospective c.ohort observational study including 78 patients with heart failure followed up at the Heart Failure Outpatient Clinic of the Internal Medicine Department. IL-6 was determined in all patients, who were then assigned into two groups according to IL-6 level (normal or high). Clinical and prognostic data were collected to determine the differences in both groups. Results: The average age was 79 years, 60% female. A total of 53.8% of the patients had elevated IL-6 (group 2). Patients with elevated IL-6 presented more frequently with anemia mellitus (64.3% vs. 41.7%; p = 0.046), atrial fibrillation (83.3% vs. 61.9% p = 0.036), dyslipidemia (76.2% vs. 58.2%; p = 0.03), higher creatinine levels (1.35 mg/dL vs. 1.08 mg/dL; p = 0.024), lower glomerular filtration rate (43.6 mL/min/m2 vs. 59.9 mL/min/m2; p = 0.007), and anemia 25% vs. 52.4% p = 0.014. The factors independently associated with the increase in IL-6 were anemia 3.513 (1.163–10.607) and renal failure 0.963 (0.936–0.991), p < 0.05. Mortality was higher in the group with elevated IL-6 levels (16% vs. 2%; p = 0.044) with a log-rank p = 0.027 in the Kaplan–Meier curve. Conclusion: Patients with heart failure and elevated IL-6 most often have atrial fibrillation, diabetes mellitus, dyslipidemia, anemia, and renal failure. In addition, mortality was higher and a tendency of higher hospital admission was observed in stable HF patients with elevated IL-6.
Highlights
Patients with elevated IL-6 (Group 2) were more likely to present with diabetes mellitus (64.3% vs. 41.7%; p = 0.046) and hypercholesterolemia
Group 1 patients had a higher frequency of atrial fibrillation compared to Group 2 (83.3% vs. 61.9%; p = 0.036)
IL-6 was elevated in a subgroup of patients with heart failure, dyslipidemia, atrial fibrillation diabetes mellitus, anemia, and chronic renal failure as already described
Summary
In response to metabolic stress, hemodynamic overload, and neurohormonal hyperactivation in the endothelium and myocardial cells, proinflammatory cytokines such as tumor necrosis factor-α (TNFα), and interleukin (IL) 1 and 6 are released. These markers favor the adaptation of the cardiovascular system to stress, but later in the course of the disease, they produce deleterious effects through endothelial and cardiac dysfunction leading to myocardial fibrosis [1]. Previous studies have shown an increase in inflammatory markers 4.0/) Such as C-reactive protein (CRP), tumor necrosis factor (TNFα), and interleukin (IL) 6 in patients with HF [2]. This allows NF-KB to translocate to the nucleus and bind cognate DNA-binding sites to regulate the transcription of a large number of genes, including inflammatory cytokines [3]
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