Inflammatory burden is linked to incident heart failure
In 6,785 adults, adjusting for four inflammatory biomarkers reduced the Black-White heart failure log-hazard difference by 57.5% relative to a clinical model.
medRxiv
In a prospective cohort of 6,785 adults from four racial and ethnic groups in the Multi-Ethnic Study of Atherosclerosis followed for approximately 16 years, researchers evaluated how baseline inflammatory markers associate with incident heart failure. Over follow-up, 485 heart failure events occurred. Four prespecified biomarkers independently associated with incident heart failure per 1-SD increment: interleukin-6 carried a hazard ratio of 1.20, D-dimer 1.18, C-reactive protein 1.14, and fibrinogen 1.13. A composite inflammatory burden index yielded a hazard ratio of 1.25 per 1-SD increase. No multiplicative race-by-biomarker interaction was detected, indicating that the hazard per standard deviation was directionally consistent across groups. Sequential biomarker adjustment reduced the Black-White log-hazard difference by 57.5% relative to a clinical-only model, and associations remained robust after adjustment for ambient air pollution.
Why it matters
Systemic inflammation and hemostatic dysregulation represent key features of cardiovascular aging that correlate with heart failure risk. The findings suggest that differing structural exposures to environmental factors, rather than innate biological susceptibility, may contribute to disparities in aging-related heart disease.
Caveats
Because the study relies on observational data, the authors note that biomarker attenuation is consistent with, but not sufficient to prove, causal mediation by inflammatory pathways. In addition, the paper is a preprint that has not yet undergone peer review.
The paper
Lynn University · RIPLRT Institute
medRxiv · 1 Oct 2026 · Preprint, not peer-reviewed