Mild inflammation increases mortality risk in heart failure patients

A moderate increase in C-reactive protein levels in the blood may indicate a less favorable prognosis for individuals with heart failure with mildly reduced ejection fraction. This protein, produced by the liver in response to systemic inflammation, is often measured to assess the body’s inflammatory state. Researchers observed that C-reactive protein levels above 5 mg per liter of blood were associated with a significant increase in the risk of death over a 30-month period, regardless of other risk factors such as age, sex, or the presence of chronic diseases.

The study involved nearly 2,000 patients hospitalized for this specific form of heart failure. The results show that the higher the level of this protein, the greater the risk of all-cause mortality. For example, patients with levels between 5 and 10 mg per liter had a 72% increased risk compared to those with levels below 5 mg per liter. For those with levels exceeding 50 mg per liter, the risk was more than twice as high. This trend was confirmed even after excluding patients with known conditions that increase this inflammatory marker, such as infections or rheumatic diseases.

Systemic inflammation, of which C-reactive protein is an indicator, plays a key role in the progression of heart failure. It can contribute to the deterioration of the heart muscle and structural changes in the heart, worsening the disease. Although this protein is not directly responsible for heart failure, its elevation reflects a state of increased vulnerability, related to age, comorbidities, and reduced physiological reserve.

Researchers emphasize that this marker, which is easy to measure and inexpensive, could serve as a practical tool for assessing long-term risk in these patients. However, it remains to be determined whether anti-inflammatory treatments could improve their prognosis. Current clinical trials are exploring this avenue, but results remain limited and inconclusive for this specific population.

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Study Citation

DOI: https://doi.org/10.1007/s00392-026-02958-8

Title: Even mild elevations of C-reactive protein levels predict long-term prognosis in heart failure with mildly reduced ejection fraction

Journal: Clinical Research in Cardiology

Publisher: Springer Science and Business Media LLC

Authors: Jonas Dudda; Michael Behnes; Michelle Goertz; Felix Lau; Alexander Schmitt; Marielen Reinhardt; Noah Abel; Svetlana Hetjens; Daniel Duerschmied; Mohammad Abumayyaleh; Ibrahim Akin; Tobias Schupp