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. 2022 Aug 30;14(8):e28605.
doi: 10.7759/cureus.28605. eCollection 2022 Aug.

Inflammation as a Prognostic Marker in Heart Failure

Priscila C Lima  1 , Davi M Rios  1 , Filipe P de Oliveira  1   2 , Larissa R Passos  1   2 , Ludmila B Ribeiro  1   2 , Renato G Serpa  1   2 , Osmar A Calil  1   2 , Lucas C de Barros  1   2 , Luiz Fernando M Barbosa  1   2 , Roberto R Barbosa  1   2
Affiliations

Inflammation as a Prognostic Marker in Heart Failure

Priscila C Lima et al. Cureus. .

Abstract

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.

Keywords: albumin; c-reactive protein; heart failure; hospitalization; inflammation; prognosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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