Key result
Elevated monocyte TNF-α production (≥4.9 pg/mL/10^6 PBMCs) and low LDL-cholesterol (<120 mg/dL) were independently associated with a significantly increased risk of cardiac events in patients with chronic heart failure.
Observational (n=95)
Yes
Hazard Ratio: 187.38 (95% CI 7.92–4434.94)
Absolute Event Rate: 91.8% vs 8.7%
p-value: p=0.001
Low LDL-cholesterol and upregulated monocyte proinflammatory cytokine production are independently associated with poor long-term outcomes in patients with chronic heart failure.
May aid risk stratification in chronic HF; hypothesis-generating for targeted interventions.
OBJECTIVE: Low serum cholesterol is associated with a poor prognosis in patients with chronic heart failure (CHF). However, the relationships between the serum cholesterol level, production of monocyte proinflammatory cytokines and long-term prognosis in CHF patients remain unclear. METHODS: A total of 95 CHF patients who had not been treated with statins and had a mean left ventricular ejection fraction of 26.0±6.0% were examined. Peripheral blood mononuclear cells (PBMCs) were isolated, and the production of monocyte tumor necrosis factor (TNF)-α and interleukin (IL)-6 was measured and expressed as the mean ± SD (pg/mL/10(6) PBMCs). RESULTS: The production of monocyte TNF-α and IL-6 was found to be significantly and negatively associated with the serum low-density lipoprotein (LDL)-cholesterol level (TNF-α: r=-0.515, p<0.001, IL-6: r=-0.419, p<0.001). During a median follow-up of 66.0 months, 49 patients developed cardiac events, including 21 cardiac deaths and 28 readmissions for worsening CHF. A multivariate Cox hazard analysis showed that a monocyte TNF-α level of ≥4.9 pg/mL/10(6) PBMCs [hazard ratio (HR) 187.38, 95% confidence interval (CI) 7.92-4,434.94, p=0.001] and LDL-cholesterol level of <120 mg/dL (HR 9.41, 95% CI 1.02-86.66, p=0.048) were independently associated with the incidence of cardiac events. CONCLUSION: Low LDL-cholesterol and the upregulation of monocyte proinflammatory cytokine production are both significantly and independently associated with poor outcomes in CHF patients.
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Nakagomi et al. (2014) conducted an observational in Chronic Heart Failure (n=95). Elevated monocyte TNF-α production (≥4.9 pg/mL/10^6 PBMCs) vs. Low monocyte TNF-α production (<4.9 pg/mL/10^6 PBMCs) was evaluated on Incidence of cardiac events (cardiac death and readmission for worsening CHF) (HR 187.38, 95% CI 7.92-4434.94, p=0.001). Elevated monocyte TNF-α production (≥4.9 pg/mL/10^6 PBMCs) and low LDL-cholesterol (<120 mg/dL) were independently associated with a significantly increased risk of cardiac events in patients with chronic heart failure.
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