Domingo A Pascual-Figal1, Antoni Bayes-Genis2, Maria C Asensio-Lopez3, Alvaro Hernández-Vicente3, Iris Garrido-Bravo3, Francisco Pastor-Perez3, Javier Díez4, Borja Ibáñez5, Antonio Lax3. 1. Cardiology Department, Hospital Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Murcia, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, España; CIBERCV, Madrid, Spain. Electronic address: dpascual@um.es. 2. CIBERCV, Madrid, Spain; Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 3. Cardiology Department, Hospital Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Murcia, Spain. 4. CIBERCV, Madrid, Spain; Departments of Nephrology, and Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, IDISNA, Pamplona, Spain. 5. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, España; CIBERCV, Madrid, Spain; IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain.
Abstract
BACKGROUND: Soluble ST2 (sST2), which is the soluble form of interleukin (IL)-1 receptor-like 1, identifies risk in acutely decompensated heart failure (ADHF). IL-1β is an inflammatory cytokine that has deleterious effects in myocardial remodeling and function. IL-1β inhibition has beneficial effects after acute myocardial infarction. However, the role of IL-1β in ADHF and its relationship to ST2 remain unclear. OBJECTIVES: This study sought to investigate the relationship between IL-1β and sST2, and the prognostic impact of such a relationship in patients with ADHF. METHODS: This study examined 316 consecutive patients who were hospitalized with ADHF (72 ± 12 years of age, 57% male, and left ventricular ejection fraction 45 ± 17%). Blood samples were collected at presentation, and IL-1β and sST2 levels were measured. All-cause mortality was obtained for all patients at 1 year. RESULTS: The IL-1β concentration at presentation was associated with prior HF hospitalizations, functional impairment, and higher N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T concentrations. IL-1β was higher in patients who died during the year after hospitalization (n = 52, 16.5%) (p = 0.005), and the optimal threshold was identified with levels over 49.1 pg/ml (hazard ratio: 2.5; 95% confidence interval: 1.43 to 4.49; p = 0.0014). Circulating IL-1β positively correlated with sST2 (ρ = 0.65; p < 0.001). Considering the prognostic thresholds of IL-1β (≥49.1 pg/ml) and sST2 (≥35.0 ng/ml) concentrations: all patients with low sST2 also presented with low IL-1β; among patients with high sST2, only those with also high IL-1β had a significantly higher risk of death (30% vs. 14%; hazard ratio: 2.52; 95% confidence interval: 1.40 to 4.56; p = 0.002). CONCLUSIONS: Circulating IL-1β concentrations are clinically meaningful in ADHF patients and interplay with the predictive ability of sST2. IL-1 axis-related inflammation signaling may represent a therapeutic target in ADHF.
BACKGROUND: Soluble ST2 (sST2), which is the soluble form of interleukin (IL)-1 receptor-like 1, identifies risk in acutely decompensated heart failure (ADHF). IL-1β is an inflammatory cytokine that has deleterious effects in myocardial remodeling and function. IL-1β inhibition has beneficial effects after acute myocardial infarction. However, the role of IL-1β in ADHF and its relationship to ST2 remain unclear. OBJECTIVES: This study sought to investigate the relationship between IL-1β and sST2, and the prognostic impact of such a relationship in patients with ADHF. METHODS: This study examined 316 consecutive patients who were hospitalized with ADHF (72 ± 12 years of age, 57% male, and left ventricular ejection fraction 45 ± 17%). Blood samples were collected at presentation, and IL-1β and sST2 levels were measured. All-cause mortality was obtained for all patients at 1 year. RESULTS: The IL-1β concentration at presentation was associated with prior HF hospitalizations, functional impairment, and higher N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T concentrations. IL-1β was higher in patients who died during the year after hospitalization (n = 52, 16.5%) (p = 0.005), and the optimal threshold was identified with levels over 49.1 pg/ml (hazard ratio: 2.5; 95% confidence interval: 1.43 to 4.49; p = 0.0014). Circulating IL-1β positively correlated with sST2 (ρ = 0.65; p < 0.001). Considering the prognostic thresholds of IL-1β (≥49.1 pg/ml) and sST2 (≥35.0 ng/ml) concentrations: all patients with low sST2 also presented with low IL-1β; among patients with high sST2, only those with also high IL-1β had a significantly higher risk of death (30% vs. 14%; hazard ratio: 2.52; 95% confidence interval: 1.40 to 4.56; p = 0.002). CONCLUSIONS: Circulating IL-1β concentrations are clinically meaningful in ADHF patients and interplay with the predictive ability of sST2. IL-1 axis-related inflammation signaling may represent a therapeutic target in ADHF.
Authors: Albert Topf; Moritz Mirna; Bernhard Ohnewein; Peter Jirak; Kristen Kopp; Dzeneta Fejzic; Michael Haslinger; Lukas J Motloch; Uta C Hoppe; Alexander Berezin; Michael Lichtenauer Journal: Front Cardiovasc Med Date: 2020-12-04
Authors: Rudolf A de Boer; Jean-Sébastien Hulot; Carlo Gabriele Tocchetti; Joseph Pierre Aboumsallem; Pietro Ameri; Stefan D Anker; Johann Bauersachs; Edoardo Bertero; Andrew J S Coats; Jelena Čelutkienė; Ovidiu Chioncel; Pierre Dodion; Thomas Eschenhagen; Dimitrios Farmakis; Antoni Bayes-Genis; Dirk Jäger; Ewa A Jankowska; Richard N Kitsis; Suma H Konety; James Larkin; Lorenz Lehmann; Daniel J Lenihan; Christoph Maack; Javid J Moslehi; Oliver J Müller; Patrycja Nowak-Sliwinska; Massimo Francesco Piepoli; Piotr Ponikowski; Radek Pudil; Peter P Rainer; Frank Ruschitzka; Douglas Sawyer; Petar M Seferovic; Thomas Suter; Thomas Thum; Peter van der Meer; Linda W Van Laake; Stephan von Haehling; Stephane Heymans; Alexander R Lyon; Johannes Backs Journal: Eur J Heart Fail Date: 2020-11-12 Impact factor: 15.534