TY - JOUR
T1 - Effects of anti-inflammatory therapy in acute heart failure
T2 - a systematic review and meta-analysis
AU - Davison, Beth A.
AU - Abbate, Antonio
AU - Cotter, Gad
AU - Pascual-Figal, Domingo
AU - Van Tassell, Benjamin
AU - Villota, Julio Núñez
AU - Atabaeva, Lina
AU - Freund, Yonathan
AU - Aimo, Alberto
AU - Biegus, Jan
AU - Golino, Michele
AU - Del Buono, Marco Giuseppe
AU - Chioncel, Ovidiu
AU - Cohen-Solal, Alain
AU - Edwards, Christopher
AU - Fernández-Villa, Noelia
AU - Filippatos, Gerasimos
AU - González-Juanatey, José Ramón
AU - Hayrapetyan, Hamlet
AU - Ibáñez, Borja
AU - Iborra, Pau Llàcer
AU - Moroni, Francesco
AU - ter Maaten, Jozine M.
AU - Markley, Roshanak
AU - González-Martín, Javier
AU - Martínez-Sellés, Manuel
AU - Drambyan, Mayranush
AU - Metra, Marco
AU - Mirabet, Sonia
AU - Mshetsyan, Andranik
AU - Novosadova, Maria
AU - Pagnesi, Matteo
AU - Ponikowski, Piotr
AU - Riquelme-Pérez, Alejandro
AU - Sadoune, Malha
AU - Sánchez, Manuel Anguita
AU - Simon, Tabassome
AU - Taibo-Urquía, Mikel
AU - Takagi, Koji
AU - Villar, Sandra
AU - Liu, Chao
AU - Voors, Adriaan A.
AU - Mebazaa, Alexandre
AU - Mann, Douglas L.
AU - Bayés-Genís, Antoni
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.
PY - 2025/5
Y1 - 2025/5
N2 - We examined current evidence regarding the effects of anti-inflammatory therapies in patients with acute heart failure (AHF) on the risk of cardiovascular outcomes, inflammatory markers, natriuretic peptides, and renal function. Despite growing evidence that inflammation plays a pivotal role in both the development and progression of heart failure, including AHF, only a few trials have been conducted to date in patients with AHF. A systematic literature search of PubMed, Medline, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted in November 2024 to identify randomized controlled trials (RCTs) evaluating anti-inflammatory therapies in adult patients with AHF. Meta-analyses were conducted to estimate effects on clinical outcomes (death, HF readmission, or worsening HF) and inflammatory and other markers. Five RCTs were identified that enrolled a total of 289 patients to an anti-inflammatory intervention and 273 to a control. Prednisone was examined in two RCTs, anakinra in two, and colchicine in one. Three of the five trials required elevated C-reactive protein (CRP) level for entry. Anti-inflammatory therapy was associated with a reduced risk of the composite outcome (hazard ratio 0.55 [95% CI 0.35–0.86]) and an overall 54% greater reduction in CRP to end of therapy (ratio of geometric mean ratios 0.46 [95% CI 0.29–0.73]), which varied across studies. NT-proBNP and creatinine were not significantly affected. The analysis is limited by the small number of studies but suggests that anti-inflammatory therapy reduces inflammation and may reduce the risk of adverse clinical outcomes in patients with AHF.
AB - We examined current evidence regarding the effects of anti-inflammatory therapies in patients with acute heart failure (AHF) on the risk of cardiovascular outcomes, inflammatory markers, natriuretic peptides, and renal function. Despite growing evidence that inflammation plays a pivotal role in both the development and progression of heart failure, including AHF, only a few trials have been conducted to date in patients with AHF. A systematic literature search of PubMed, Medline, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted in November 2024 to identify randomized controlled trials (RCTs) evaluating anti-inflammatory therapies in adult patients with AHF. Meta-analyses were conducted to estimate effects on clinical outcomes (death, HF readmission, or worsening HF) and inflammatory and other markers. Five RCTs were identified that enrolled a total of 289 patients to an anti-inflammatory intervention and 273 to a control. Prednisone was examined in two RCTs, anakinra in two, and colchicine in one. Three of the five trials required elevated C-reactive protein (CRP) level for entry. Anti-inflammatory therapy was associated with a reduced risk of the composite outcome (hazard ratio 0.55 [95% CI 0.35–0.86]) and an overall 54% greater reduction in CRP to end of therapy (ratio of geometric mean ratios 0.46 [95% CI 0.29–0.73]), which varied across studies. NT-proBNP and creatinine were not significantly affected. The analysis is limited by the small number of studies but suggests that anti-inflammatory therapy reduces inflammation and may reduce the risk of adverse clinical outcomes in patients with AHF.
KW - Acute heart failure
KW - Anti-inflammatory agents
KW - Inflammation
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85218265463&partnerID=8YFLogxK
U2 - 10.1007/s10741-025-10491-5
DO - 10.1007/s10741-025-10491-5
M3 - Review article
C2 - 39939545
AN - SCOPUS:85218265463
SN - 1382-4147
VL - 30
SP - 575
EP - 587
JO - Heart Failure Reviews
JF - Heart Failure Reviews
IS - 3
ER -