Key result
Higher IL-1β linked to ~25% higher mortality in chronic Chagas cardiomyopathy.
Why the study?
Chronic Chagas cardiomyopathy (CCC) is a severe form of Chagas disease with limited data on the prognostic and functional value of biomarkers such as BNP, Ca-125, C-reactive protein, uric acid, and cytokines.
Cohort (n=50)
No
Answers are grounded in this paper and cite their sources.
Does not support changing practice based on IL-1β levels; leaves open whether IL-1 inhibition improves survival in Chagas cardiomyopathy.
The primary objective was to observe the relationship between serum levels of BNP, Ca-125, C-reactive protein and uric acid as prognostic and functional markers in patients with chronic Chagas cardiomyopathy (CCC). Circulating levels of cytokines: IL-1β, TNFα, IL-10, IL6, IL-8 and IL-12 were determined and investigated regarding their association with hemodynamic parameters, clinical signs of heart failure and outcome. Chagas is still a neglected disease that affects numerous individuals, many of them in their most productive years. CCC with left ventricular dysfunction is the most severe presentation of Chagas Disease. BNP is a well-recognized prognostic and clinical biomarker, not only in chronic heart failure patients but also in patients with CCC. Previous studies have shown Ca-125, C-reactive protein, and uric acid to be potentially good prognostic markers in heart failure (HF). Fifty patients with left ventricular fraction less (LVEF) than 55% were selected and followed for a mean period of 18 ± 8.3 months. Patient’s mean age was 43.42 ± 10.3 years (32 male), their BNP was 293 (160–530) pg/mL, Ca-125 8.5 (5.5–16.75) U/mL, uric acid 6.2 ± 2 mg/dL, and C- reactive protein 4.5 (4.5–7.3) mg/L. Patients who had LVEF less than 35% had higher BNP (p = 0.0023), Ca-125 (p = 0.027) and uric acid (p = 0.01) serum levels. Patients who died also showed higher BNP (p = 0.01), uric acid (p = 0.05) and a trend towards higher Ca-125 serum levels (p = 0.056). All markers: BNP, Ca-125, uric acid and C-reactive had good predictability of death in Cox-regression univariate analysis, however, not on the final multivariate model. Of the inflammatory cytokines, IL-8 and IL-12 showed a relation to LVEF of less than 35%. IL-12 was related to adverse cardiovascular events and non-survival. IL-1β was a good predictor of mortality in the final Cox regression model. Determination of Ca-125, uric acid levels and C-reactive protein may add useful clinical and prognostic information and may help clinical decision making for patients with CCC.
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Rodrigues et al. (2022) conducted a cohort in Chronic Chagas Cardiomyopathy (n=50). Elevated IL-1β vs. Lower IL-1β levels was evaluated on Mortality (HR 1.254, 95% CI 1.068-1.472, p=0.006). In patients with chronic Chagas cardiomyopathy, higher serum levels of IL-1β were a significant independent predictor of mortality (HR 1.254).
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