Heart failure & cardiomyopathiesMeta-analysis
Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction
- Pooled cross-sectional analysis of 3 randomised trials
Authors' conclusion
Systemic inflammation is present in one-half of patients with HF, and is associated with excess body fat, chronic kidney disease, albuminuria, and diabetes, and increases with comorbidity burden. These relationships are not specific to HFpEF/HFmrEF but are also common to HFrEF
Study context
- Population
- Patients with heart failure (HF) in 3 large outcome trials (SELECT, SOUL, FLOW)3 trials
- Participants
- 3,204 / 1,246 / 1,018
- Comparison
- Heart Failure with Preserved Ejection Fraction (HFpEF) vs Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF) vs Heart Failure and Reduced Ejection Fraction (HFrEF)
- HFpEFn = 3,204
- HFmrEFn = 1,246
- HFrEFn = 1,018
- Outcome
- Prevalence of systemic inflammation (hsCRP ≥2 mg/L)
Pooled result
As reported in the abstract
Elevated hsCRP (≥2 mg/L)
Further pooled results
Correlates of higher high-sensitivity C-reactive protein (hsCRP)
- Higher hsCRP more likely female, obesity, DM, lower eGFR, higher albuminuria, COPD; no meaningful differences by HF subtype
hsCRP vs EF and comorbidity count
- hsCRP unrelated to EF
- R2 < 0.001; P = 0.73
- hsCRP increased linearly with number of comorbidities, all HF subtypes
- R2 = 0.94; P < 0.001
Original publication
Prevalence and Associations of Systemic Inflammation in Heart Failure Across the Spectrum of Ejection Fraction. JACC Heart Fail. Published 16 October 2025. doi:10.1016/j.jchf.2025.102712
Summarised from the published abstract; every number is checked against it