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. 2010 May 11;55(19):2129-37.
doi: 10.1016/j.jacc.2009.12.045.

Inflammatory markers and incident heart failure risk in older adults: the Health ABC (Health, Aging, and Body Composition) study

Andreas Kalogeropoulos  1 , Vasiliki Georgiopoulou, Bruce M Psaty, Nicolas Rodondi, Andrew L Smith, David G Harrison, Yongmei Liu, Udo Hoffmann, Douglas C Bauer, Anne B Newman, Stephen B Kritchevsky, Tamara B Harris, Javed Butler; Health ABC Study Investigators
Affiliations

Inflammatory markers and incident heart failure risk in older adults: the Health ABC (Health, Aging, and Body Composition) study

Andreas Kalogeropoulos et al. J Am Coll Cardiol. .

Abstract

Objectives: The purpose of this study was to evaluate the association between inflammation and heart failure (HF) risk in older adults.

Background: Inflammation is associated with HF risk factors and also directly affects myocardial function.

Methods: The association of baseline serum concentrations of interleukin (IL)-6, tumor necrosis factor-alpha, and C-reactive protein (CRP) with incident HF was assessed with Cox models among 2,610 older persons without prevalent HF enrolled in the Health ABC (Health, Aging, and Body Composition) study (age 73.6 +/- 2.9 years; 48.3% men; 59.6% white).

Results: During follow-up (median 9.4 years), HF developed in 311 (11.9%) participants. In models controlling for clinical characteristics, ankle-arm index, and incident coronary heart disease, doubling of IL-6, tumor necrosis factor-alpha, and CRP concentrations was associated with 29% (95% confidence interval: 13% to 47%; p < 0.001), 46% (95% confidence interval: 17% to 84%; p = 0.001), and 9% (95% confidence interval: -1% to 24%; p = 0.087) increase in HF risk, respectively. In models including all 3 markers, IL-6, and tumor necrosis factor-alpha, but not CRP, remained significant. These associations were similar across sex and race and persisted in models accounting for death as a competing event. Post-HF ejection fraction was available in 239 (76.8%) cases; inflammatory markers had stronger association with HF with preserved ejection fraction. Repeat IL-6 and CRP determinations at 1-year follow-up did not provide incremental information. Addition of IL-6 to the clinical Health ABC HF model improved model discrimination (C index from 0.717 to 0.734; p = 0.001) and fit (decreased Bayes information criterion by 17.8; p < 0.001).

Conclusions: Inflammatory markers are associated with HF risk among older adults and may improve HF risk stratification.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Heart Failure Rates According to the Number of Elevated Inflammatory Markers at Baseline
Adjusted Kaplan-Meier plots illustrating cumulative heart failure incidence among Health ABC Study participants according to the number of elevated inflammatory markers (interleukin-6, tumor necrosis factor alpha, or C-reactive protein) at baseline. Adjustment model included all baseline characteristics as described in Table 1.
See this image and copyright information in PMC

Comment in

References

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