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April 23, 2021
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Biomarkers of inflammation tied to HF hospitalization in patients with AF

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Among patients with atrial fibrillation, biomarkers of inflammation were associated with hospitalization for HF, researchers reported.

The researchers found elevated levels of log-transformed high-sensitivity C-reactive protein and log-transformed interleukin-6 (IL-6) conferred poor outcomes, as did a high inflammation score.

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Source: Adobe Stock

“Our study suggests that inflammation is an important predictor of hospitalization for heart failure and other adverse outcomes in patients with atrial fibrillation,” Alexander P. Benz, MD, research fellow at the Population Health Research Institute in Hamilton, Ontario, Canada, and colleagues wrote.

The researchers analyzed 3,784 patients with AF (median age, 72 years; 24% with prior HF).

According to the researchers, the median plasma levels of hsCRP and IL-6 at baseline were 1.64 mg/L (interquartile range [IQR], 0.81-3.69) and 3.42 pg/mL (IQR, 2.14-5.6), respectively. Benz and colleagues calculated an inflammation score between 0 and 4 for each patient, with 1 point awarded for a biomarker between the 50th and 75th percentile and 2 points awarded for a biomarker above the 75th percentile.

Researchers found that hospitalization for HF occurred in 11.8% of patients, with an incidence rate of 3.04 per 100 person-years.

After multivariable adjustment, at 4 years, both biomarkers were significantly associated with risk for HF hospitalization (adjusted HR for log-transformed hsCRP per 1 increase in standard deviation [SD] = 1.22; 95% CI, 1.11-1.34; P < .001; aHR for log-transformed IL-6 per 1 increase in SD = 1.48; 95% CI, 1.35-1.62; P < .001) .

According to the researchers, the inflammation score was strongly linked to the risk for HF hospitalization even after multivariable adjustment (HR = 2.43; 95% CI, 1.8-3.3; P for trend < .001).

“The question of whether or not treatments targeted at inflammatory pathways can improve outcomes in patients with AF should be evaluated in randomized clinical trials,” the researchers wrote.