Serum inflammatory factors as predictors of severity and prognosis in heart failure: A cohort study

血清炎症因子作为心力衰竭严重程度和预后的预测指标:一项队列研究

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Abstract

Chronic heart failure (HF) progression is closely linked to inflammatory pathways, yet the prognostic value of specific serum inflammatory biomarkers remains underexplored. This study aims to investigate the association between serum inflammatory factors and disease severity/1-year prognosis in patients hospitalized with chronic HF. A total of 524 patients who were hospitalized with HF in the Second Affiliated Hospital of Dalian Medical University between January 1, 2019 and June 30, 2022 were included. General data, New York Heart Association grade of cardiac function, biochemical data, serum inflammatory factors, and echocardiographic findings were recorded. Patients were followed up for 1 year and recorded endpoint events. Patients were categorized based on serum inflammatory factor levels into high- and low-level groups using the median method. One-way analysis was used to analyze changes in inflammatory factors among patients with HF with different cardiac function grades. Risk factors for cardiac function classification were analyzed using logistic regression. Kaplan-Meier survival curve analysis was used to compare the incidence of endpoint events in patients with different inflammatory factor levels, and COX proportional risk regression analysis was further used to assess the predictors of endpoint events in patients with HF. All data were analyzed using the SPSS 27.0 (IBM [IBM SPSS Statistics], Chicago). Interleukin 2 receptor and interleukin 6 levels differed among the different cardiac function grades in patients with HF. Multiple logistic regression analysis shows that patients with higher interleukin 2 receptor and interleukin 1β had higher grade of cardiac function. Patients with higher interleukin 2 receptor and interleukin 6 levels were more likely to have a major adverse cardiovascular events event within 1 year. Kaplan-Meier survival curve analysis revealed that the survival rate of the high interleukin 1β, interleukin 2 receptor and interleukin 6 level groups was significantly lower than that of the low-level group. COX regression analysis revealed that lower tumor necrosis factor-α levels (hazard ratio [HR] [95% CI] = 0.68 [0.466-0.922] P = .046), and high interleukin 1β (HR [95% CI] = 1.936 [1.343-2.791], P < .001), interleukin 2 receptor (HR [95% CI] = 2.237 [1.367-3.66], P = .001), and interleukin 6 (HR [95% CI] = 2.388 [1.57-3.633], P < .001) levels were independent risk factors for endpoint events in patients with chronic HF. interleukin 2 receptor, interleukin 6, and interleukin 1β predict the severity and prognosis of patients with chronic HF.

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