Interleukin-1 Blockade Reduces Nt-Probnp Serum Levels in Patients With Stable Heart Failure With Preserved Ejection Fraction

Trankle, Cory R.; Canada, Justin M.; Carbone, Salvatore; Buckley, Leo F.; Buono, Marco Giuseppe Del; Christopher, Sanah; Kadariya, Dinesh; Vo, Chau; Abouzaki, Nayef; Arena, Ross; Tassell, Benjamin Van; Abbate, Antonio

doi:10.1016/s0735-1097(18)31410-4

Cited by 2 publications

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“…In a follow up study, the Diastolic Heart Failure Anakinra Response Trial-2 (DHART-2), patients with stable symptomatic HFpEF were treated with Anakinra to confirm the effects on peak VO 2 and CRP and observe its effects on serum NT-proBNP (46). Twenty-eight patients completed two visits or more and Anakinra was found to significantly reduce CRP as well as NT-proBNP levels.…”

Section: Discussionmentioning

confidence: 99%

“…The potential benefits of IL-1 blockade in patients with heart disease is further supported by the results of the phase III Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) (47), in which patients with prior acute myocardial infarction were randomized to canakinumab, IL-1β blocker, or placebo, and showed a significant reduction in major adverse cardiac events. A small single-center sub-study of the CANTOS trial showed a significant improvement in peak VO 2 in canakinumab-treated patients at 3 and 12 months (46).…”

Section: Discussionmentioning

confidence: 99%

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C-Reactive Protein and N-Terminal Pro-brain Natriuretic Peptide Levels Correlate With Impaired Cardiorespiratory Fitness in Patients With Heart Failure Across a Wide Range of Ejection Fraction

Wezenbeek

Canada

Ravindra

et al. 2018

Front. Cardiovasc. Med.

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Background: Impaired cardiorespiratory fitness (CRF) is a hallmark of heart failure (HF). Serum levels of C-reactive protein (CRP), a systemic inflammatory marker, and of N-terminal pro-brain natriuretic peptide (NT-proBNP), a biomarker of myocardial strain, independently predict adverse outcomes in HF patients. Whether CRP and/or NT-proBNP also predict the degree of CRF impairment in HF patients across a wide range of ejection fraction is not yet established.Methods: Using retrospective analysis, 200 patients with symptomatic HF who completed one or more treadmill cardiopulmonary exercise tests (CPX) using a symptom-limited ramp protocol and had paired measurements of serum high-sensitivity CRP and NT-proBNP on the same day were evaluated. Univariate and multivariate correlations were evaluated with linear regression after logarithmic transformation of CRP (log10) and NT-proBNP (logN).Results: Mean age of patients was 57 ± 10 years and 55% were male. Median CRP levels were 3.7 [1.5–9.0] mg/L, and NT-proBNP levels were 377 [106–1,464] pg/ml, respectively. Mean peak oxygen consumption (peak VO2) was 16 ± 4 mlO2•kg−1•min−1. CRP levels significantly correlated with peakVO2 in all patients (R = −0.350, p < 0.001) and also separately in the subgroup of patients with reduced left ventricular ejection fraction (LVEF) (HFrEF, N = 109) (R = −0.282, p < 0.001) and in those with preserved EF (HFpEF, N = 57) (R = −0.459, p < 0.001). NT-proBNP levels also significantly correlated with peak VO2 in all patients (R = −0.330, p < 0.001) and separately in patients with HFrEF (R = −0.342, p < 0.001) and HFpEF (R = −0.275, p = 0.032). CRP and NT-proBNP did not correlate with each other (R = 0.05, p = 0.426), but independently predicted peak VO2 (R = 0.421, p < 0.001 and p < 0.001, respectively).Conclusions: Biomarkers of inflammation and myocardial strain independently predict peak VO2 in HF patients. Anti-inflammatory therapies and therapies alleviating myocardial strain may independently improve CRF in HF patients across a large spectrum of LVEF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%