Interleukin-1β levels predict long-term mortality and need for heart transplantation in ambulatory patients affected by idiopathic dilated cardiomyopathy
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Aneta Aleksova1, Antonio Paolo Beltrami2, Cosimo Carriere1, Giulia Barbati1, Pierluigi Lesizza1, Martina Perrieri-Montanino1, Miriam Isola2, Piero Gentile1, Elisabetta Salvioni3, Tarcisio Not4, Piergiuseppe Agostoni3, Gianfranco Sinagra1
1Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste, Trieste, Italy
2Department of Medical and Biological Sciences, University of Udine, Italy
3Centro Cardiologico Monzino, IRCCS, Milan, Italy, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
4Institute for Maternal and Child Health, IRCCS “Burlo Garofolo” Trieste and University of Trieste, Trieste, Italy
Antonio Paolo Beltrami, email: firstname.lastname@example.org
Keywords: idiopathic dilated cardiomyopathy, long-term outcome, heart failure, interleukin 1 beta, brain natriuretic peptide
Received: October 12, 2016 Accepted: January 09, 2017 Published: February 15, 2017
Aims: The prognostic stratification of patients with Idiopathic Dilated Cardiomyopathy (iDCM) is a difficult task. Here, we assessed the additive value of the evaluation of biomarkers of inflammasome activation and systemic inflammation for the long-term risk stratification of iDCM patients.
Methods and Results: We studied 156 ambulatory iDCM patients (mean age 58 years, 77% men, 79% in NYHA class 1-2, median Left Ventricular Ejection Fraction (LVEF) 35%, mean sodium 139 mEq/L, median BNP 189 pg/mL, median IL-1 beta (IL-1β) 1.08 pg/mL, median IL-6 1.7 pg/mL and median IL-10 2.7 pg/mL).
During the follow-up period of 89.6 months, 35 patients (22%) died/underwent heart transplantation. Patients who died/underwent heart transplantation were more likely to be male, to be in NYHA class III, to have atrial fibrillation, to have lower LVEF and higher BNP levels. IL-1β, IL-6 and IL-10 levels did not differ significantly between the groups of patients with good or bad prognosis. IL-1β levels did not vary significantly among either the different NYHA classes or the quartiles of LVEF. In a multivariable model, however, IL-1β was a strong and independent predictor of all-cause mortality (HR 1.193, 95% CI 1.056 – 1.349, p=0.005 for log squared transformed values). Other factors associated with the outcome were: male gender, presence of atrial fibrillation and sodium concentration. The estimated time-dependent ROC curve of the multivariable model showed an AUC 0.74 (95% CI 0.65-0.86).
Conclusions: Serum levels of IL-1β could be useful to predict the long-term outcome of patients with iDCM.
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