Utilidad de la interleukina-6 y de la proteína C reactiva ultrasensible como marcadores pronósticos en pacientes ambulatorios con insuficiencia cardíaca y fracción de eyección reducida

  1. Chirino Navarta, Daniel Agustín; Servicio de Cardiología de la Unidad Asistencial Por Más Salud Dr. César Milstein, Ciudad Autónoma de Buenos Aires; Servicio de Cardiología del Sanatorio Franchín, Ciudad Autónoma de Buenos Aires; 1
  2. Trejo, Graciela 2
  3. Leonardi, Mariela Susana 2
  4. Fossati, María Pía 3
  5. Gurfinkel, Mirta 4
  6. Tellechea, Francisco 5
  7. Rodriguez Vazquez, María Luisa 6
  8. Dizeo, Claudio 7
  1. 1 Servicio de Cardiología de la Unidad Asistencial Por Más Salud Dr. César Milstein, Ciudad Autónoma de Buenos Aires (Argentina)
  2. 2 Coordinadora Unidad Coronaria, Hospital César Milstein
  3. 3 Laboratorio Central, Hospital César Milstein
  4. 4 Jefa Laboratorio Central, Hospital César Milstein
  5. 5 Medico de planta, Servicio Cardiología, Hospital César Milstein
  6. 6 Medica de planta Servicio Cardiología, Hospital César Milstein
  7. 7 Jefe del Servicio de Cardiología, Hospital César Milstein
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Revista:
Revista Argentina de Cardiología (RAC)

Año de publicación: 2020

Volumen: 88

Número: 3

Páginas: 194-200

Tipo: Artículo

DOI: 10.7775/AJC.88.3.17251 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Resumen

Objetivo. Evaluar si la Interleukina-6 (IL-6) y la Porteína C Reactiva ultrasensible (PCRus) asociadas al Péptido Natriurético tipo B (BNP) son marcadores independientes de eventos en pacientes ambulatorios con Insuficiencia cardíaca con fracción de eyección reducida (IC-FEr).Materiales y MétodosSe incluyeron en forma prospectiva pacientes mayores de 65 años con IC-FEr que se siguen en forma ambulatoria. Se realizó medición basal de BNP, IL-6 y PCR-us. Se excluyeron los pacientes con IC post infarto de miocardio reciente (< 6 meses), con internación reciente (<3 meses) por cuadro que pueda aumentar los marcadores inflamatorios. Se consideró el punto final combinado de mortalidad de cualquier causa e internación por insuficiencia cardíaca descopensada (ICD).ResultadosSe incluyeron 130 pacientes, edad de 75 ± 5 años, con FE de 33 ± 11%. Con un seguimiento de 450 ± 210 días, el punto combinado se observó en el 31.5% (n = 41). En el análisis multivariado, el BNP elevado (>442) y la IL-6 elevada (>7.2) fueron predictores independientes del punto primario (HR 2.60 (IC95% 1.14-5.9), p = 0.02 y HR 2.49 (IC95% 1.08-5.7), p = 0.03, respectivamente), no así la PCR-us (>6.9), con p=0.2.  La IL-6 presentó un área bajo la curva (ABC) de 0.70, el BNP 0.73 y la PCRus 0.63, sin diferencias significativas entre las curvas.Conclusiones El BNP y la IL6 fueron marcadores independientes del punto combinado, no así la PCRus. La capacidad de discriminación de la IL6 y el BNP fue moderada.

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Fuente de los datos: Dialnet