Elevated VCAM-1 was an independent predictor of mortality (HR 4.7; 95% CI 1.1-18.7; P=0.030), and TNF-α predicted disease exacerbation in patients with chronic heart failure.
Observational (n=189)
Do elevated levels of inflammatory markers (VCAM-1, TNF-α) predict mortality and disease exacerbation in patients with chronic heart failure?
Elevated serum VCAM-1 and TNF-α levels serve as independent predictors of mortality and disease exacerbation, respectively, in patients with chronic heart failure, aiding in risk stratification.
Hazard Ratio: 4.7 (95% CI 1.1–18.7)
p-value: p=0.030
BACKGROUND: To assess the prognostic significance of four inflammatory markers (TNF-α, high sensitive C-reactive protein (hs-CRP), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1)) in chronic heart failure (CHF) patients with respect to individual outcomes, especially disease exacerbation and mortality. METHODS: Plasma adhesion molecules, ICAM-1, and VCAM-1, together with TNF-α and hs-CRP were determined in 120 CHF patients and 69 healthy controls. Endothelial function was also estimated by flow-mediated brachial artery dilatation. RESULTS: Increased levels of all investigated inflammatory markers were found in CHF patients compared to controls, with the rise more pronounced in New York Heart association (NYHA) functional IV class. Significant correlations were obtained for VCAM-1 and brain natriuretic peptide (r = 0.191; P = 0.038), as well as, ICAM-1 and endothelium-dependent vasodilatation (r = -0.235; P = 0.01). Kaplan-Meier analysis showed disease exacerbation in patients with TNF-α levels >2.78 pg/ml significantly shorter compared to those with TNF-α levels 4.76 mg/l (log-rank test = 5.052; P = 0.025) and VCAM-1 levels >1200 ng/l (log-rank test = 5.45; P = 0.020) with respect to mortality. Cox regression analysis demonstrated only VCAM-1 (HR = 4.7; 95% confidence interval (CI): 1.1-18.7; P = 0.030) as independent death predictor, while TNF-α was associated with disease exacerbation (HR = 8.2; 95%CI: 1.1-23.0; P = 0.045). CONCLUSIONS: VCAM-1 appears to be useful in risk stratification of CHF patients and in screening, to identify subjects at risk for heart failure related events.
Savić-Radojević et al. (Thu,) conducted a observational in Chronic heart failure (n=189). Elevated VCAM-1 and TNF-α vs. Lower levels of VCAM-1 and TNF-α was evaluated on Mortality (HR 4.7, 95% CI 1.1-18.7, p=0.030). Elevated VCAM-1 was an independent predictor of mortality (HR 4.7; 95% CI 1.1-18.7; P=0.030), and TNF-α predicted disease exacerbation in patients with chronic heart failure.