The relationship of the erythrocyte sedimentation rate to inflammatory cytokines and survival in patients with chronic heart failure treated with angiotensin-converting enzyme inhibitors

OBJECTIVES The object of the study was to assess the relationship between erythrocyte sedimentation rate (ESR) and inflammatory cytokine production in chronic heart failure (CHF). Our findings lead us to re-evaluate the prognostic value of the ESR in assessing patients with CHF. BACKGROUND The searc...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2000-08, Vol.36 (2), p.523-528
Main Authors: Sharma, Rakesh, Rauchhaus, Mathias, Ponikowski, Piotr P, Varney, Susan, Poole-Wilson, Philip A, Mann, Douglas L, Coats, Andrew J.S, Anker, Stefan D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biological and medical sciences
Blood Sedimentation
Cardiovascular system
Cytokines - blood
Heart Failure - drug therapy
Heart Failure - mortality
Humans
Interleukin-6 - blood
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Survival Analysis
Tumor Necrosis Factor-alpha - analysis
Vasodilator agents. Cerebral vasodilators
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Summary:OBJECTIVES The object of the study was to assess the relationship between erythrocyte sedimentation rate (ESR) and inflammatory cytokine production in chronic heart failure (CHF). Our findings lead us to re-evaluate the prognostic value of the ESR in assessing patients with CHF. BACKGROUND The search for simple prognostic markers in CHF that can be assessed anywhere at low cost is important. Increases in ESR are related to the acute phase response in states of inflammation and infection. METHODS Initially, we studied ESR in relation to plasma levels of inflammatory cytokines in 58 CHF patients. The findings prompted us to analyze the mortality predictive power of ESR compared with established risk factors in these patients and (retrospectively) in a second group of 101 clinically stable CHF patients who had ESR measured. RESULTS In all 159 CHF patients (age 62 ± 2 years, New York Heart Association [NYHA] class 2.7 ± 0.1), ESR ranged from 1 to 96 mm/h (median 14 mm/h). The ESR was correlated with tumor necrosis factor (TNF)-alpha (r = 0.31, p < 0.05), soluble TNF receptor-1 (r = 0.48, p < 0.0005), soluble TNF receptor-2 (r = 0.39, p < 0.005) and interleukin 6 (r = 0.45, p < 0.005) levels. High ESR levels indicated a poor prognosis (p < 0.0001), and this was independent of age, NYHA class, ejection fraction and peak oxygen consumption (p < 0.005). Patients with ESR above median (≥15 mm/h) compared with patients with ESR
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(00)00745-2