Inflammatory Biomarkers and ECG Repolarization Metrics: Sudden Death in Heart Failure With Reduced Ejection Fraction

doi:10.1016/j.jacadv.2026.102922

Heart failure & cardiomyopathies

Inflammatory Biomarkers and Electrocardiogram (ECG) Repolarization Metrics: Sudden Death in Heart Failure With Reduced Ejection Fraction

JACC AdvPublished 17 Jun 2026Cox proportional hazards and linear regression models

Main finding · SCD by JTc intervalResultHazard ratio 0.97 per 10 ms 95% CI 0.94–1.00

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Authors' conclusion

Inflammatory biomarkers, particularly hsCRP, are independently associated with SCD in patients with HFrEF and provide prognostic value beyond ECG parameters. These findings suggest that inflammation likely contributes to SCD risk through pathways distinct from repolarization prolongation. Biomarkers such as hsCRP may be useful to incorporate into risk stratification.

Study context

Population: Patients with heart failure with reduced ejection fraction (HFrEF) and recent decompensation in the VICTORIA trialpatients with core lab-adjudicated ECGs and baseline biomarkers
Participants: 4,391 patients

Comparison: Inflammatory biomarkers (interleukin-6, growth differentiation factor-15, high-sensitivity C-reactive protein (hsCRP)) and ECG repolarization intervals (QTc, JTc) in relation to sudden cardiac death (SCD)

Methodological detailscore lab-adjudicated ECGs, baseline biomarkers

Core lab-adjudicated ECGs
Baseline biomarkers

Main finding

SCD by JTc interval

Hazard ratio

0.97 per 10 ms

95% CI 0.94–1.00

P = 0.043

JTc interval

HR 0.97 per 10 ms (95% CI 0.94–1.00); P = 0.043

Per 10 ms, as printed

As reported in the abstract

Further findings

Outcome	HR (per doubling)	P value
SCD by inflammatory biomarkers · multivariable models	1.20	P < 0.001

SCD by inflammatory biomarkers

All 3 biomarkers associated with increased SCD risk in univariable analysis; only hsCRP remained significant in multivariable models

QTc and JTc intervals by growth differentiation factor-15

Growth differentiation factor-15 independently associated with QTc and JTc intervals

Prognostic value added to covariate-adjusted JTc interval model

hsCRP provided the greatest prognostic value (new information): 16%
P: P < 0.001

Original publication

Inflammatory Biomarkers and ECG Repolarization Metrics: Sudden Death in Heart Failure With Reduced Ejection Fraction. JACC Adv. Published 17 June 2026. doi:10.1016/j.jacadv.2026.102922

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it