Inflammation and long-term mortality in acute congestive heart failure

Mueller, Christian; Laule-Kilian, Kirsten; Christ, Andreas; Rocca, Hans Peter Brunner–La; Perruchoud, André P.

doi:10.1016/j.ahj.2005.06.046

Cited by 119 publications

(76 citation statements)

References 18 publications

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“…[7][8][9][10] Inflammatory cytokines and other biomarkers such as high-sensitivity C-reactive protein (hs-CRP) are elevated in patients with heart failure and are predictive of worse clinical outcomes. [11][12][13][14] Conversely, low cholesterol is an independent predictor of a poor prognosis in heart failure. 15,16 Heart failure is therefore an inflammatory state in which the usual epidemiological relationship between cholesterol and cardiovascular outcomes is reversed and thus represents an excellent disease model in which to test the statin antiinflammatory hypothesis.…”

Section: Clinical Perspective On P 2196mentioning

confidence: 99%

Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

et al. 2009

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Background-We examined whether the antiinflammatory action of statins may be of benefit in heart failure, a state characterized by inflammation in which low cholesterol is associated with worse outcomes. Methods and Results-We compared 10 mg rosuvastatin daily with placebo in patients with ischemic systolic heart failure according to baseline high sensitivity-C reactive protein (hs-CRP) Ͻ2.0 mg/L (placebo, nϭ779; rosuvastatin, nϭ777) or Ն2.0 mg/L (placebo, nϭ1694; rosuvastatin, nϭ1711). The primary outcome was cardiovascular death, myocardial infarction, or stroke. Baseline low-density lipoprotein was the same, and rosuvastatin reduced low-density lipoprotein by 47% in both hs-CRP groups. Median hs-CRP was 1.10 mg/L in the lower and 5.60 mg/L in the higher hs-CRP group, with higher hs-CRP associated with worse outcomes. The change in hs-CRP with rosuvastatin from baseline to 3 months was Ϫ6% in the low hs-CRP group (27% with placebo) and Ϫ33.3% in the high hs-CRP group (Ϫ11.1% with placebo). In the high hs-CRP group, 548 placebo-treated (14.0 per 100 patient-years of follow-up) and 498 rosuvastatin-treated (12.2 per 100 patient-years of follow-up) patients had a primary end point (hazard ratio of rosuvastatin to placebo, 0.87; 95% confidence interval, 0.77 to 0.98; Pϭ0.024). In the low hs-CRP group, 175 placebo-treated (8.9 per 100 patient-years of follow-up) and 188 rosuvastatin-treated (9.8 per 100 patient-years of follow-up) patients experienced this outcome (hazard ratio, 1.09; 95% confidence interval, 0.89 to 1.34; PϾ0.2; P for interactionϭ0.062). The numbers of deaths were as follows: 581 placebo-treated (14.1 per 100 patient-years of follow-up) and 532 rosuvastatin-treated (12.6 per 100 patient-years) patients in the high hs-CRP group (hazard ratio, 0.89; 95% confidence interval, 0.79 to 1.00; Pϭ0.050) and 170 placebo-treated (8.3 per 100 patient-years) and 192 rosuvastatin-treated (9.7 per 100 patient-years) patients in the low hs-CRP group (hazard ratio, 1.17; 95% confidence interval, 0.95 to 1.43; Pϭ0.14; P for interactionϭ0.026). Conclusion-In this retrospective hypothesis-generating study, we found a significant interaction between hs-CRP and the effect of rosuvastatin for most end points whereby rosuvastatin treatment was associated with better outcomes in patients with hs-CRP Ն2.0 mg/L. Clinical Trial Registration Information-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00206310.

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Section: Clinical Perspective On P 2196mentioning

confidence: 99%

Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

et al. 2009

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“…Mueller et al 17 retrospectively studied 214 ADHF patients treated at the emergency unit who were followed up for 24 months. Mortality rates from the first to the third tercile in CRP values were, respectively, 33.5%, 42.2%, and 53.6%.…”

Section: Resultsmentioning

confidence: 99%

Proteína C-reativa: marcador inflamatório com valor prognóstico em pacientes com insuficiência cardíaca descompensada

Villacorta¹,

Masetto²,

Mesquita³

2007

Arq. Bras. Cardiol.

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“…Mueller, et al evaluated the prognostic role of inflammation among 214 consecutive patients presenting with acute heart failure at the emergency department. 50) Patients in the highest CRP tertile significantly more often required admission to the intensive care unit (33% versus 14%, P = 0.028) and died in hospital (15% versus 2%, P = 0.027) compared to the first tertile. After multivariate adjustment, CRP remained an independent predictor of death (hazard ratio, 1.4; 95% CI, 1.1 -1.8; P = 0.044).…”

Section: )mentioning

confidence: 99%

Biomarkers in Heart Failure

Takeishi

2014

Int. Heart J.

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SummaryAppropriate use of biomarkers is clinically important for identifying heart failure in its early stage, optimizing risk stratification, and managing patients. This article describes established and traditional biomarkers as well as novel biomarkers reflective of myocardial stress, myocardial damage, extracellular matrix, oxidative stress, inflammation, renal function, micro RNAs, and heart failure with preserved left ventricular ejection fraction. This review focuses on the recent advances in cardiac and non-cardiac biomarkers of heart failure and their appropriate use in clinical practice. (Int Heart J 2014; 55: 474-481) Key words: BNP, NT-proBNP, ST2, Troponin, H-FABP, Galectin-3, Cystatin C, Pentraxin 3 C ardiovascular diseases are the predominant cause of death in developed countries. Among the afflicted, patients with heart failure are increasing, and this complex syndrome is becoming a public health problem, especially with the aging of populations. To establish diagnostic, therapeutic, and prognostic strategies, the identification of reliable biomarkers for heart failure is necessary.1,2) Although a number of biomarkers have been developed, the ideal biomarkers should meet certain criteria: 1) non-invasive sample collection, 2) a high degree of sensitivity and specificity, 3) able to detect the disease at an early stage, 4) sensitivity high enough to reflect relevant changes in disease conditions, 5) a long halflife within the sample, 6) rapid measurement system responding to clinical needs, and 7) low cost. 3,4) In this article, the focus will be on the recent advances in cardiac and non-cardiac biomarkers of heart failure and their appropriate use in clinical practice. Myocardial Stress MarkersB-type natriuretic peptide: B-type natriuretic peptide (BNP) is a well-established biomarker, extensively used for the diagnosis and prognosis of patients with heart failure. BNP is a cardiac hormone, identified as the second compound of the natriuretic peptide family and secreted predominantly from the ventricle in response to mechanical overload. 5) In the failing heart, increased wall stress and neurohormonal activation facilitate BNP secretion chiefly from ventricular myocytes. BNP promotes diuresis, vasodilatation, and attenuation of renin and aldosterone secretion. Tsutamoto, et al initially measured plasma levels of BNP in 85 patients with chronic heart failure and a left ventricular ejection fraction (LVEF) of less than 0.45. 6)The plasma levels of BNP increased in proportion to the severity of heart failure. Plasma levels of BNP were 5-fold higher in non-survivors than in survivors. Among clinical and hemodynamic parameters, Cox proportional hazard analysis revealed that only plasma BNP (P < 0.0001) and pulmonary capillary wedge pressure (P = 0.003) were significant independent predictors of mortality in patients with heart failure. Plasma levels of BNP provided prognostic information independent of other variables previously associated with a poor prognosis. To date, a number of studies have r...

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Inflammation and long-term mortality in acute congestive heart failure

Cited by 119 publications

References 18 publications

Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

Proteína C-reativa: marcador inflamatório com valor prognóstico em pacientes com insuficiência cardíaca descompensada

Biomarkers in Heart Failure

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