Serially Measured Cytokines and Cytokine Receptors in Relation to Clinical Outcome in Patients With Stable Heart Failure

Autor: Tjeerd Germans, Victor A. Umans, K.M. Akkerhuis, H. Boersma, Anne-Sophie Schuurman, Sara J. Baart, Isabella Kardys, Jasper J. Brugts, Kadir Caliskan, Elke Bouwens, J. van Ramshorst
Přispěvatelé: Cardiology
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Oncology
Chemokine
medicine.medical_specialty
medicine.medical_treatment
030204 cardiovascular system & hematology
Risk Assessment
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
B-Cell Activating Factor
Outcome Assessment
Health Care
medicine
Clinical endpoint
Humans
Assisted Circulation
Prospective Studies
030212 general & internal medicine
Receptors
Cytokine
Receptor
Prospective cohort study
Netherlands
Heart Failure
Heart transplantation
Ejection fraction
biology
business.industry
Receptors
Interleukin-1
Atrial fibrillation
Middle Aged
Brain natriuretic peptide
medicine.disease
Cytokine
Heart failure
Ventricular assist device
Immunology
biology.protein
Cytokines
Heart Transplantation
Biomarker (medicine)
Female
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Biomarkers
Interleukin-1
Blood sampling
Zdroj: Canadian Journal of Cardiology, 36(10), 1587-1591. Elsevier Inc.
ISSN: 1916-7075
0828-282X
DOI: 10.1016/j.cjca.2020.08.010
Popis: Background Activation of the inflammatory response in heart failure (HF) may initially serve as a compensatory mechanism. However, on the longer term, this physiological phenomenon can become disadvantageous. Temporal patterns of inflammatory proteins other than CRP have not yet been investigated in patients with stable HF. Purpose We aimed to evaluate the association of 17 serially measured cytokines and cytokine receptors with clinical outcome in patients with stable heart failure. Methods In 263 patients, 1984 serial, tri-monthly blood samples were collected during a median follow-up of 2.2 (IQR: 1.4–2.5) years. The primary endpoint (PE) composed of cardiovascular mortality, HF-hospitalization, heart transplantation, and LVAD. We selected baseline blood samples in all patients, as well as the two samples closest to the primary endpoint, and the last sample available in event-free patients. Thus, in 567 samples we measured 17 cytokines and cytokine receptors using the Olink Proteomics Cardiovascular III multiplex assay. Associations between biomarkers and PE were investigated by joint modelling. Results Median age was 68 (IQR: 59–76) years, with 72% men, 74% NYHA class I-II and a median ejection fraction of 30% (23–38%). 70 patients reached a PE. After adjustment for clinical characteristics (age, sex, diabetes, atrial fibrillation, NYHA class at baseline, diuretics and systolic blood pressure), 7 biomarkers were associated with the PE (Figure). Interleukin-1 receptor type 1 (IL1RT1) showed the strongest association: HR 2.65 [95% CI: 1.78–4.21]) per standard deviation change in level (NPX) at any point in time during follow-up, followed by Tumor necrosis factor receptor 1 (TNF-R1): 2.25 [1.66–3.08], and C-X-C motif chemokine 16 (CXCL16): 2.18 [1.59–3.04]. After adjustment for baseline N-terminal pro–B-type natriuretic peptide, high-sensitive troponin T and C-reactive protein however, only IL1RT1 and TNF-R1 remained significantly associated with the PE. Conclusion Repeatedly measured levels of several cytokines and cytokine receptors are independently associated with clinical outcome in stable HF patients. These results suggest that repeated measurements of these biomarkers, in addition to established cardiac biomarkers, may contribute to personalized risk assessment and herewith better identify high-risk patients. Figure 1. Associations between levels of cytokines and cytokine receptors and the primary endpoint. Funding Acknowledgement Type of funding source: Other. Main funding source(s): This work was supported by the Jaap Schouten Foundation and the Noordwest Academie.
Databáze: OpenAIRE
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