The Additive Prognostic Value of Serial Plasma Interleukin-6 Levels over Changes in Brain Natriuretic Peptide in Patients with Acute Heart Failure

George Markousis-Mavrogenis, Jasper Tromp, Robert J. Mentz, Christopher M. O'Connor, Marco Metra, Piotr Ponikowski, John R. Teerlink, Gad Cotter, Beth Davison, John G. F. Cleland, Michael M. Givertz, Dirk J. Van Veldhuisen, Hans L. Hillege, Adriaan A. Voors, Peter Van der Meer*

*Corresponding author for this work

Research output: Contribution to journalLetterAcademicpeer-review

3 Citations (Scopus)
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Background: Elevated plasma interleukin-6 (IL-6) concentrations are frequently observed in patients with acute heart failure (AHF). However, the predictive value of serial IL-6 measurements beyond brain natriuretic peptide (BNP) remains poorly characterized.

Methods and Results: This was a retrospective analysis of the PROTECT cohort (2033 patients with AHF). Plasma IL-6 and BNP levels were determined on days 1, 2, 7 and 14 after admission for AHF in 1591 (78.3%), 1462 (71.9%), 1445 (71.1%) and 1451 (71.4%) patients, respectively. The primary endpoint was 180-day all-cause mortality. The median day-1 IL-6 concentration was 11.1 pg/mL (IQR: 6.6, 20.9) and decreased to 10.1 pg/mL (IQR: 5.6-18.5) at day-7. Higher cross-sectional IL-6 concentrations at all time-points predicted the primary endpoint, independent of a risk model for this cohort and changes in BNP. Each doubling of IL-6 between day-1 and day-7 predicted the primary endpoint independent of baseline IL-6 concentrations, the risk model, baseline BNP and changes in BNP [HR (95% CI): 1.18 (1.07-1.30), p=0.0013]. Collectively, 214 (17%) patients experienced at least a doubling of their IL-6 concentrations between day-1 and day-7.

Conclusions: We demonstrate that the temporal evolution patterns of IL-6 in patients with AHF have additive prognostic value independent of changes in BNP.

Original languageEnglish
Pages (from-to)808-811
Number of pages4
Issue number7
Publication statusPublished - Jul-2021


  • Serial
  • change
  • IL-6
  • BNP
  • NT-proBNP
  • landmark

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