Prednisone’s Role in Combating Inflammation in Heart Failure
Overview
Steroid treatments, typically used for respiratory illnesses, could also help patients with acute heart failure (AHF) by addressing inflammation—a major factor in worsening outcomes. The CORTAHF trial investigated whether a short course of prednisone could lower inflammation and improve recovery in patients with AHF. A total of 101 patients with AHF and high inflammatory markers were divided into two groups—one received 40 mg of prednisone daily for 7 days, while the other group received standard care. Over a 90-day period, the study found that patients who took prednisone had better outcomes, with fewer heart failure complications and improvements in quality of life compared to those who received standard treatment.
At the end of the first week, both groups experienced a reduction in the inflammation marker hsCRP, but the decrease was more significant in the prednisone group. After 90 days, 10.4% of patients in the prednisone group experienced heart failure-related complications or death, compared to 30.8% in the standard care group. Moreover, those taking prednisone reported a greater improvement in their overall quality of life.
Introduction
For many years, scientists have known that inflammation plays a key role in heart failure (HF). Research has shown that elevated levels of C-reactive protein (CRP) in patients with acute heart failure are associated with worse outcomes, such as higher rates of hospital readmissions and increased mortality. While the link between inflammation and heart failure is well understood, few therapies have directly targeted inflammation in AHF.
In the past, attempts to use anti-inflammatory drugs like TNF-α inhibitors to treat heart failure didn’t produce significant benefits, which led many to question this approach. However, more recent studies using drugs like anakinra (which blocks IL-1 receptors) have shown encouraging results, such as better fluid control in heart failure patients. In addition, retrospective studies have suggested that corticosteroids like prednisone could benefit AHF patients with high hsCRP levels, which provided the rationale for the CORTAHF trial.
This study aimed to evaluate whether prednisone, a cost-effective anti-inflammatory drug, could reduce inflammation, improve quality of life, and prevent serious complications in AHF patients by targeting the inflammatory processes that worsen heart failure.
Also read Heart Failure Polygenic Risk Predictions
Methods
The CORTAHF trial enrolled patients aged 18 to 85 with AHF who showed signs of fluid buildup in their lungs, as confirmed by chest X-ray or ultrasound, and had elevated biomarkers like NT-proBNP and hsCRP. The study excluded individuals with other conditions that might interfere with the results, such as severe anemia, acute coronary syndrome, or active infections. Participants were randomly assigned to either a 7-day course of 40 mg of prednisone or standard care alone.
The primary objective was to observe changes in hsCRP levels after 7 days. Secondary outcomes included the time to worsening heart failure, hospital readmission, or death within 90 days, along with improvements in patients’ quality of life. Safety was also carefully monitored, with special attention to potential side effects like hyperglycemia, a common issue with steroid use.
Results
After 7 days, the group taking prednisone had a more significant drop in hsCRP levels compared to those receiving standard care. Over the next 90 days, the prednisone group also experienced fewer adverse events, such as heart failure worsening, hospital readmission, or death.
In addition, patients who took prednisone reported a noticeable improvement in their quality of life after just one week, as measured by the EQ-5D scale. This effect was especially pronounced in patients with higher levels of IL-6, another inflammation marker.
While prednisone was associated with an increased occurrence of mild hyperglycemia, no severe cases were reported, and the infection rates were similar between both groups.
Conclusion
The CORTAHF trial suggests that short-term prednisone treatment for patients with acute heart failure can significantly reduce inflammation and improve clinical outcomes, including quality of life. Though prednisone led to more mild cases of hyperglycemia, the benefits—such as reduced heart failure complications—appear to outweigh these risks. These findings open the door to a potential new treatment strategy for AHF patients, though further research is needed to confirm these results and refine the approach for broader use.
Oncology Related Tools
Other
Latest Research
