Predictive value of circulating inflammatory biomarkers for readmission and mortality risk in patients with heart failure with reduced ejection fraction

During 12 months, 142 of 454 patients (31.3%) experienced the primary endpoint. After adjustment for prespecified clinical covariates and NT-proBNP, hs-CRP, IL-6, sST2, and GDF-15 remained associated with the endpoint, whereas TNF-α did not. An exploratory post hoc model combining the four statistically significant biomarkers increased the apparent C-index from 0.712 to 0.756, with category-free NRI of 0.267 and IDI of 0.058 at 12 months.

Serial biomarker findings were treated as descriptive because the final sample could coincide with an endpoint event. These results suggest that selected inflammatory and stress biomarkers contain complementary prognostic information, but external validation, calibration, treatment-adjusted sensitivity analyses, and source-level handling of incomplete follow-up are required before clinical use.</p>