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We aimed to assess the possible role of systemic inflammation in the pathophysiology, phenotyping, and risk stratification of patients with AHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Using a novel Interleukin-6 immunoassay with unprecedented sensitivity (limit of detection 0.01\u2009ng\/L), we quantified systemic inflammation in unselected patients presenting with acute dyspnoea to the emergency department in a multicentre study. One-year mortality was the primary prognostic endpoint. Among 2042 patients, 1026 (50.2%) had an adjudicated diagnosis of AHF, 83.7% of whom had elevated interleukin-6 concentrations (&amp;gt;4.45\u2009ng\/L). Interleukin-6 was significantly higher in AHF patients compared to patients with other causes of dyspnoea (11.2 [6.1\u201326.5] ng\/L vs. 9.0 [3.2\u201332.3] ng\/L, p &amp;lt;\u20090.0005). Elevated interleukin-6 concentrations were independently predicted by increasing N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin T, as well as the clinical diagnosis of infection. Among the different AHF phenotypes, interleukin-6 concentrations were highest in patients with cardiogenic shock (25.7 [14.0\u2013164.2] ng\/L) and lowest in patients with hypertensive AHF (9.3 [4.8\u201321.6] ng\/L, p =\u20090.001). Inflammation as quantified by interleukin-6 was a strong and independent predictor of 1-year mortality both in all AHF patients, as well as those without clinically overt infection at presentation (adjusted hazard ratio [95% confidence interval] 1.45 [1.15\u20131.83] vs. 1.48 [1.09\u20132.00]). The addition of interleukin-6 significantly improved the discrimination of the BIOSTAT-CHF risk score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An unexpectedly high percentage of patients with AHF have subclinical systemic inflammation as quantified by interleukin-6, which seems to contribute to AHF phenotype and to the risk of death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2767","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T04:30:49Z","timestamp":1672806649000},"page":"174-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Quantifying Inflammation Using Interleukin-6 for Improved Phenotyping and Risk Stratification in Acute Heart Failure"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-1451","authenticated-orcid":false,"given":"Eleni","family":"Michou","sequence":"first","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desiree","family":"Wussler","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Belkin","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Simmen","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Strebel","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albina","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Clinical Nutrition, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Division of Internal Medicine, University Psychiatry Clinic Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Kozhuharov","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samyut","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Lopez-Ayala","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Sabti","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Mork","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Diebold","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"P\u00e9quignot","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Rentsch","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"von Eckardstein","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Gualandro","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute 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