Clinical Implications of Different Biomarkers in Elderly Patients with Heart Failure

Abstract

Aims: The aim of this article was to determine the importance of neuroendocrine and inflammatory biomarkers in elderly patients (>70 years) with heart failure (HF). Methods: 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. Results: 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. Conclusion: In elderly patients with HF, the determination of biomarkers may be helpful to establish those patients at higher risk.

Keywords::

• biomarkers
• BNP
• C-reactive protein
• cystatin C
• elderly patients
• heart failure
• IL-6
• IL-18
• TNF-α

Acknowledgements

The authors thank P Pons from Content Ed Net Madrid for assistance in submitting the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert t­estimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate insti­tutional review board approval or have followed the princi­ples outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investi­gations involving human subjects, informed consent has been obtained from the participants involved.