Clinical implications of different biomarkers in elderly patients with heart failure

Abstract

Aims: The aim of this article was to determine the importance of neuroendocrine and inflammatory biomarkers in elderly patients (>70 years) with heart failure (HF). Methods: In this retrospective and observational study, TNF-α, IL-6, IL-18, Fas (Apo1), BNP, C-reactive protein and cystatin C values were calculated, as well as the relationship between them and the clinical evolution of patients. Results: A total of 124 patients (mean age ± standard deviation: 83 ± 5 years) were included. After a mean follow-up of 2.4 years, 40.3% of patients were hospitalized for HF and 15.3% of patients died. Those patients who were hospitalized for HF compared with those that did not were hospitalized for HF showed higher values of IL-6 (9.8 ± 13.1 vs 4.65 ± 5.8 pg/ml; p = 0.003) and those who died compared with those who are alive higher values of IL-18 (437.1 ± 137.4 vs 299.7 ± 167.2 pg/ml; p = 0.01), C-reactive protein (12.6 ± 19.4 vs 6.1 ± 9.4 mg/l; p = 0.03), BNP (704.2 ± 428.6 vs 418.5 ± 410.6 pg/ml; p = 0.008) and cystatin C (1.76 ± 0.6 vs 1.45 ± 0.5 mg/l; p = 0.04). In the multivariate analysis, only IL-18 (hazard ratio: 1.4; 95% CI: 1.05–1.8; p = 0.027) remained as an independent predictor for mortality. Conclusion: In elderly patients with HF, the determination of biomarkers may be helpful to establish those patients at higher risk.