Serum Levels of sCD40L, CCL3, and NT-proBNP in Elderly Patients Admitted to the Hospital with HF

The authors investigated the serum levels of sCD40L (soluble CD40 Ligand), the pro-inflammatory chemokine CCL3, and N-terminal pro b-type natriuretic peptide (NT-proBNP) in elderly patients admitted to the hospital with HF. The study explored whether screening these biomarkers individually or in combination can serve as a diagnostic tool for HF associated with VTELL. The presence of thrombi was determined through venous ultrasound of the lower limbs during hospital admission. Evaluating 200 patients divided into groups with and without thrombosis, the researchers found that the groups presented similar characteristics, with the exception of lipoprotein levels, which were significantly higher in the thrombosis group. The combined analysis of NT-proBNP, sCD40L, and CCL3 yielded a sensitivity of 62.00% and a specificity of 91.00%. This associated analysis proved superior to the individual performance of each biomarker, utilizing thresholds of 264.93 pg/mL for NT-proBNP, 7.07 ng/mL for sCD40L, and 28.96 ng/L for CCL3, thereby highlighting the diagnostic value of the combination for this specific patient profile.

The relevance of these findings is supported by existing literature, such as the work published by Haller et al., which investigated incremental prognostic outcomes of NT-proBNP plus other biomarkers for risk stratification in patients with atrial fibrillation. Their findings suggested that future use of multiple biomarkers could help distinguish between higher and lower risk levels in complex cardiac patients. Similarly, Folsom et al. conducted a six-year longitudinal follow-up through the “Atherosclerosis Risk in Communities” study, evaluating serial measurements of NT-proBNP. Their data showed that patients with an NT-proBNP increase from 100 to ≥100 pg/mL presented a 1.4 times increased risk for venous thromboembolism compared to those with stable, lower concentrations. When levels were consistently ≥100 pg/mL, the risk rose to 1.6 times. This suggests that rising NT-proBNP levels serve as an indicator of imminent cardiac vulnerability, predisposing patients to thromboembolic events.

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