Inflammatory Biomarkers in Heart Failure: Clinical Perspectives on hsCRP, IL-6 and Emerging Candidates.

PURPOSE OF REVIEW: Heart failure (HF) remains a leading cause of morbidity and mortality worldwide. Increasing evidence highlights that systemic low-grade inflammation is a key pathophysiological driver of HF. This review seeks to examine the diagnostic and therapeutic relevance of inflammatory biomarkers - specifically interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) - and evaluate their potential for improving risk stratification and enabling personalized treatment approaches in HF. RECENT FINDINGS: IL-6 and hsCRP have emerged as important markers of residual inflammatory risk in HF. Elevated levels of these biomarkers are associated with increased risk of incident HF and adverse outcomes in established disease. While hsCRP is as a downstream marker of inflammation with no causal involvement, Mendelian randomization studies support a causal role of IL-6 signaling in the development of HF and coronary artery disease. Recent and ongoing clinical trials support the concept of targeting inflammatory pathways as a therapeutic strategy in selected HF populations. Inflammatory biomarkers, particularly IL-6 and hsCRP, are promising tools for advancing precision medicine in HF by improving individual risk assessment and guiding anti-inflammatory interventions. Further large-scale studies are needed to validate the integration of inflammatory biomarkers into clinical algorithms for HF and explore their potential role in future guideline recommendations and personalized prevention strategies.

Duke Scholars

Author Marat Fudim Medicine, Cardiology