Adding CRP and LAVI to a conventional clinical model provided substantial incremental prognostic information for 6-month heart-failure readmission in HFrEF, although external validation is required before clinical implementation.
Thirty percent of the 150 clinically stable HFrEF patients were readmitted for heart-failure decompensation within 6 months.
Readmitted patients had significantly higher baseline NT-proBNP, fibrinogen, CRP and LAVI than non-readmitted patients.
CRP and LAVI independently predicted readmission in the primary multivariable model.
Adding CRP and LAVI to a clinical model substantially improved discrimination for 6-month readmission.
The authors conclude that inflammatory and left-atrial remodelling measures should complement, not replace, established clinical risk factors, pending external validation.
This study followed 150 stable patients with heart failure with reduced pumping function (75 with ischaemic and 75 with idiopathic dilated cardiomyopathy) for six months. About 3 in 10 (45 patients) were readmitted to hospital for worsening heart failure. Those readmitted had higher blood levels of inflammation markers (CRP and fibrinogen), higher NT-proBNP (a standard heart-strain marker), and larger left atria relative to body size (measured as LAVI) at the start. When the researchers combined these measures with usual clinical risk factors, CRP and LAVI each independently predicted readmission. A model including them distinguished patients who were and were not readmitted much better (bootstrap-corrected AUC 0.944) than a model with clinical factors alone (0.828). This research suggests that routinely available inflammation tests and a heart ultrasound measure of left atrial size could add useful information for judging early readmission risk, alongside standard clinical assessment. However, the study was done at a single centre with a modest sample, and the authors say the results need to be confirmed in other populations before being used in practice.
Vladutu C, Tieranu E, Rocsoreanu A, Militaru C, Militaru S, Neagoe C. (2026). Inflammatory Biomarkers and Left Atrial Remodelling for Early Risk Stratification of 6-Month Readmission in Ischaemic and Idiopathic Dilated Cardiomyopathy.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62101884