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<p>Interleukin-6 (IL-6) plays a role in acute heart failure (AHF) and can predict death and re-hospitalization. However, the relationship between IL-6 levels and mortality, based on heart failure phenotype, remains unclear. This study aimed to clarify the association between IL-6 levels and mortality in patients with AHF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). A retrospective observational study was conducted on 371 AHF cases admitted to our institution. Patients were categorized into two groups based on IL-6 levels using Receiver Operating Characteristic (ROC) curve analysis: those with IL-6 below 29.0&#xa0;pg/mL (N = 239) and those above 29.0&#xa0;pg/mL (N = 132). Mortality rates were assessed for both HFrEF and HFpEF patients to determine the differential impact of IL-6. The average age was 71&#xa0;years, with 60% male. Over a median follow-up of 222&#xa0;days, 53 patients (14.8%) died. Kaplan–Meier analysis revealed a significantly higher mortality rate in patients with IL-6 levels above 29.0&#xa0;pg/mL (<i>P</i> &lt; 0.001). Elevated IL-6 levels were associated with increased mortality in both categories of left ventricular ejection fraction. In particular, among patients with HFrEF, those with elevated IL-6 levels exhibited a higher risk of death after 30&#xa0;days (<i>P</i> = 0.017), while HFpEF patients with elevated IL-6 levels had a higher risk of death within 30&#xa0;days (<i>P</i> = 0.002). Elevated IL-6 levels predicted higher all-cause mortality in both HFrEF and HFpEF patients. The effect of elevated IL-6 on mortality varies between short-term and long-term implications for HFrEF and HFpEF.</p>

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Differential prognostic impact of interleukin-6 in acute heart failure with reduced versus preserved ejection fraction

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月30日

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  • Makoto Kishihara,
  • Yuichiro Minami,
  • Hidetoshi Hattori,
  • Shintaro Haruki,
  • Junichi Yamaguchi

摘要

Interleukin-6 (IL-6) plays a role in acute heart failure (AHF) and can predict death and re-hospitalization. However, the relationship between IL-6 levels and mortality, based on heart failure phenotype, remains unclear. This study aimed to clarify the association between IL-6 levels and mortality in patients with AHF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). A retrospective observational study was conducted on 371 AHF cases admitted to our institution. Patients were categorized into two groups based on IL-6 levels using Receiver Operating Characteristic (ROC) curve analysis: those with IL-6 below 29.0 pg/mL (N = 239) and those above 29.0 pg/mL (N = 132). Mortality rates were assessed for both HFrEF and HFpEF patients to determine the differential impact of IL-6. The average age was 71 years, with 60% male. Over a median follow-up of 222 days, 53 patients (14.8%) died. Kaplan–Meier analysis revealed a significantly higher mortality rate in patients with IL-6 levels above 29.0 pg/mL (P < 0.001). Elevated IL-6 levels were associated with increased mortality in both categories of left ventricular ejection fraction. In particular, among patients with HFrEF, those with elevated IL-6 levels exhibited a higher risk of death after 30 days (P = 0.017), while HFpEF patients with elevated IL-6 levels had a higher risk of death within 30 days (P = 0.002). Elevated IL-6 levels predicted higher all-cause mortality in both HFrEF and HFpEF patients. The effect of elevated IL-6 on mortality varies between short-term and long-term implications for HFrEF and HFpEF.