Objective To investigate the clinical value of serum chemokine C-C motif ligand 19(CCL19) and CCL21 levels in hospitalized patients with heart failure (HF).

Methods  A total of 221 hospitalized HF patients were enrolled in the Department of Cardiology, South Hospital of Fujian Provincial Hospital from December 2018 to October 2021 (heart failure group), and 55 healthy people in the same period served as the control group, and they were followed up regularly after discharge. Serum CCL19 and CCL21 levels were detected by enzyme-linked immunosorbent assay and baseline clinical data was collected. Time-dependent receiver operating characteristic curve (ROC), Kaplan-Meier survival curves and Cox regression analysis were used to assess the prognostic value of CCL19 and CCL21 on HF.

Results Finally, 170 patients with HF were included. The median follow-up time was 722.5 (396.5, 898.0) d, 30 all-cause deaths and 78 composite endpoint events (including all-cause death, acute myocardial infarction, malignant arrhythmia, sudden death and heart failure readmission) occurred. Patients in HF group had higher concentrations of CCL19 and CCL21 than subjects in non-HF group. In multivariate Cox regression models, CCL19, CCL21 and both CCL19 and CCL21 elevated were associated with higher risk of all-cause mortality HR(95%CI): 3.904 (1.561−9.760); 3.946 (1.561−9.978); 6.048 (2.646−13.824). CCL21 and both CCL19 and CCL21 elevated were associated with higher risk of composite endpoint events HR(95%CI): 2.204 (1.350−3.599); 1.883 (1.157−3.066). Time-dependent ROC indicated that the elevation of CCL19, CCL21 and CCL19 combined with CCL21 could better predict all-cause death at each time point and the occurrence of long-term composite endpoint events in patients with HF. Kaplan-Meier curve showed that patients with elevated serum CCL19, CCL21, and CCL19 combined with CCL21 had a higher incidence of all-cause mortality and composite endpoint events (all P＜0.05).

Conclusions Serum CCL19 and CCL21 levels are significantly increased in patients with HF. Both serum CCL19 and CCL21 are associated with all-cause mortality in patients with HF. Elevated CCL21 is associated with composite endpoint events in patients with HF.