Systemic Inflammation is Associated With Adverse Outcomes for Veterans With Heart Failure

Key Takeaways:

• Veterans with heart failure (HF) with preserved ejection fraction (HFpEF) or mildly reduced ejection fraction (HFmrEF) were assessed to determine the effects of systemic inflammation (SI) on patient outcomes.
• Veterans with SI had higher rates of atrial fibrillation, chronic kidney disease (CKD), and diabetes mellitus than those without SI.
• Rates of death, hospitalization, and emergency department (ED) visits were higher among patients with SI.

SI has been associated with worse patient outcomes for a variety of conditions. A study focused on the impact of SI on veterans with HF.

Study Population and Patient Characteristics

The study identified veterans with HFpEF or HFmrEF who underwent high-sensitivity C-reactive protein (hsCRP) testing between 2008 and 2022.

The study assessed rates of death, hospitalization or ED visits due to HF, myocardial infarction (MI), stroke, and revascularization.

A total of 49 986 veterans with HFpEF or HFrEF were identified. The hsCRP test results are as follows: 8696 <2 mg/L; 25 352 ≥2 mg/L and ≤10 mg/L; and 15 938 >10 mg/L. Patients with an hsCRP <2 mg/L did not have SI.

The Impact of SI on HF

Patients with SI had a higher risk of atrial fibrillation (44.6% vs 39.6%), CKD (29.2% vs 23.6%), and diabetes mellitus (54.8% vs 46.8%) than patients without SI.

Veterans with SI had a slightly higher average ejection fraction than veterans without (56.1% vs 55.7%).

After adjustment, veterans with SI had higher rates of death, hospitalization due to HF, and ED HF visits.

According to the study’s authors, “SI was associated with higher risk of death and HF-related events among those with HFpEF/HFmrEF, which persists after adjustment for comorbidities and treatment.”

Reference

Sandhu AT, Furst A, Varshney A, et al. Systemic inflammation associated with adverse heart failure outcomes: insights from the Veterans Affairs healthcare system. J Cardiac Failure. 2026;32(1):32329. doi:10.1016/j.cardfail.2025.11.391