At the Heart Failure Society of America annual meeting, researchers presented a subanalysis of the POSEIDON registry showing that elevated high-sensitivity C-reactive protein (hsCRP) was present in 50.8% of U.S. patients with heart failure with preserved ejection fraction, 44.7% with mildly reduced ejection fraction, and 50.3% with reduced ejection fraction. These figures were higher than the global registry rates of about 38% across the same phenotypes, indicating a disproportionately high inflammatory burden among U.S. patients.
Marat Fudim of Duke University, who presented the findings, said comorbidities such as obesity, diabetes, and chronic kidney disease are key drivers of the inflammation. He noted that residual inflammatory risk persisted despite guideline-directed medical therapy and suggested hsCRP is a practical biomarker for identifying patients at higher risk and motivating lifestyle changes.
The presentation comes after Novo Nordisk announced in September that two trials of the IL-6 inhibitor ziltivekimab in heart failure patients with high hsCRP—HERMES and ATHENA—were stopped early for futility. Ziltivekimab had also failed to reduce major adverse cardiovascular events in the earlier ZEUS trial. Fudim said he would not prioritize IL-6 again, advocating instead for broader approaches that target multiple inflammatory pathways while being cautious not to over-suppress the immune system.