Cargando…

Inflammation as a Prognostic Marker in Heart Failure

Background: Heart failure (HF) is a chronic cardiac disease of great importance worldwide and responsible for one-fifth of hospitalizations for cardiovascular disease in Brazil. Pro-inflammatory mediators are involved in the pathophysiology of HF. However, the impact of inflammatory markers on the p...

Descripción completa

Detalles Bibliográficos
Autores principales: Lima, Priscila C, Rios, Davi M, de Oliveira, Filipe P, Passos, Larissa R, Ribeiro, Ludmila B, Serpa, Renato G, Calil, Osmar A, de Barros, Lucas C, Barbosa, Luiz Fernando M, Barbosa, Roberto R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522525/
https://www.ncbi.nlm.nih.gov/pubmed/36185864
http://dx.doi.org/10.7759/cureus.28605
_version_ 1784800086892478464
author Lima, Priscila C
Rios, Davi M
de Oliveira, Filipe P
Passos, Larissa R
Ribeiro, Ludmila B
Serpa, Renato G
Calil, Osmar A
de Barros, Lucas C
Barbosa, Luiz Fernando M
Barbosa, Roberto R
author_facet Lima, Priscila C
Rios, Davi M
de Oliveira, Filipe P
Passos, Larissa R
Ribeiro, Ludmila B
Serpa, Renato G
Calil, Osmar A
de Barros, Lucas C
Barbosa, Luiz Fernando M
Barbosa, Roberto R
author_sort Lima, Priscila C
collection PubMed
description Background: Heart failure (HF) is a chronic cardiac disease of great importance worldwide and responsible for one-fifth of hospitalizations for cardiovascular disease in Brazil. Pro-inflammatory mediators are involved in the pathophysiology of HF. However, the impact of inflammatory markers on the prognosis of the disease remains uncertain. Objective: We aimed to evaluate inflammation as a prognostic marker in chronic HF. Methods: In this prospective, single-center, observational cohort study conducted from June 2018 through December 2019, we included outpatients with HF from a specialized service of a teaching hospital. Patients with decompensated HF requiring hospitalization in the last 30 days were excluded. At the time of inclusion, serum C-reactive protein (CRP) and albumin were collected and the presence of inflammation was defined as CRP/albumin ≥1.2. Patients with CRP/albumin ratio <1.2 (group A) and CRP/albumin ratio ≥1.2 (group B) were compared. The primary outcome was all-cause mortality. The secondary outcomes were hospitalization for decompensated HF, number of hospitalizations, and number of days of hospitalization in the 12-month follow-up. Results: We included 77 patients, 49 (63.3%) in group A and 28 (3.4%) in group B. Six patients in group A (12.2%) and 10 patients in group B (35.7%) required at least one hospitalization during follow-up (p=0.01). The rate of hospitalizations for decompensated HF for every 100 patients was 16.3 in group A vs 50.0 in group B (p=0.0001) and the average in-hospital length of stay was 12.2 vs 14.2 days per hospitalized patient (p=0.36) in groups A and B, respectively. The mortality rate was 6.1% in group A vs 7.1% in group B (p=0.86). Conclusion: In HF outpatients with inflammation evidentiated by the CRP/albumin ratio ≥1.2, the risk of death was similar to patients without inflammation criteria. However, the presence of inflammation led to a three-fold higher risk of hospitalization for HF decompensation.
format Online
Article
Text
id pubmed-9522525
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-95225252022-09-30 Inflammation as a Prognostic Marker in Heart Failure Lima, Priscila C Rios, Davi M de Oliveira, Filipe P Passos, Larissa R Ribeiro, Ludmila B Serpa, Renato G Calil, Osmar A de Barros, Lucas C Barbosa, Luiz Fernando M Barbosa, Roberto R Cureus Cardiology Background: Heart failure (HF) is a chronic cardiac disease of great importance worldwide and responsible for one-fifth of hospitalizations for cardiovascular disease in Brazil. Pro-inflammatory mediators are involved in the pathophysiology of HF. However, the impact of inflammatory markers on the prognosis of the disease remains uncertain. Objective: We aimed to evaluate inflammation as a prognostic marker in chronic HF. Methods: In this prospective, single-center, observational cohort study conducted from June 2018 through December 2019, we included outpatients with HF from a specialized service of a teaching hospital. Patients with decompensated HF requiring hospitalization in the last 30 days were excluded. At the time of inclusion, serum C-reactive protein (CRP) and albumin were collected and the presence of inflammation was defined as CRP/albumin ≥1.2. Patients with CRP/albumin ratio <1.2 (group A) and CRP/albumin ratio ≥1.2 (group B) were compared. The primary outcome was all-cause mortality. The secondary outcomes were hospitalization for decompensated HF, number of hospitalizations, and number of days of hospitalization in the 12-month follow-up. Results: We included 77 patients, 49 (63.3%) in group A and 28 (3.4%) in group B. Six patients in group A (12.2%) and 10 patients in group B (35.7%) required at least one hospitalization during follow-up (p=0.01). The rate of hospitalizations for decompensated HF for every 100 patients was 16.3 in group A vs 50.0 in group B (p=0.0001) and the average in-hospital length of stay was 12.2 vs 14.2 days per hospitalized patient (p=0.36) in groups A and B, respectively. The mortality rate was 6.1% in group A vs 7.1% in group B (p=0.86). Conclusion: In HF outpatients with inflammation evidentiated by the CRP/albumin ratio ≥1.2, the risk of death was similar to patients without inflammation criteria. However, the presence of inflammation led to a three-fold higher risk of hospitalization for HF decompensation. Cureus 2022-08-30 /pmc/articles/PMC9522525/ /pubmed/36185864 http://dx.doi.org/10.7759/cureus.28605 Text en Copyright © 2022, Lima et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Lima, Priscila C
Rios, Davi M
de Oliveira, Filipe P
Passos, Larissa R
Ribeiro, Ludmila B
Serpa, Renato G
Calil, Osmar A
de Barros, Lucas C
Barbosa, Luiz Fernando M
Barbosa, Roberto R
Inflammation as a Prognostic Marker in Heart Failure
title Inflammation as a Prognostic Marker in Heart Failure
title_full Inflammation as a Prognostic Marker in Heart Failure
title_fullStr Inflammation as a Prognostic Marker in Heart Failure
title_full_unstemmed Inflammation as a Prognostic Marker in Heart Failure
title_short Inflammation as a Prognostic Marker in Heart Failure
title_sort inflammation as a prognostic marker in heart failure
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522525/
https://www.ncbi.nlm.nih.gov/pubmed/36185864
http://dx.doi.org/10.7759/cureus.28605
work_keys_str_mv AT limapriscilac inflammationasaprognosticmarkerinheartfailure
AT riosdavim inflammationasaprognosticmarkerinheartfailure
AT deoliveirafilipep inflammationasaprognosticmarkerinheartfailure
AT passoslarissar inflammationasaprognosticmarkerinheartfailure
AT ribeiroludmilab inflammationasaprognosticmarkerinheartfailure
AT serparenatog inflammationasaprognosticmarkerinheartfailure
AT calilosmara inflammationasaprognosticmarkerinheartfailure
AT debarroslucasc inflammationasaprognosticmarkerinheartfailure
AT barbosaluizfernandom inflammationasaprognosticmarkerinheartfailure
AT barbosarobertor inflammationasaprognosticmarkerinheartfailure