© 2007 European Society of Cardiology
B-type natriuretic peptide levels predict event-free survival in patients with implantable cardioverter defibrillators
a Klinik für Innere Medizin Kardiologie, Germany
b Klinik für Innere Medizin, Institut für Klinische Chemie Universität Marburg, Germany
c Departement Medizin, Med. Klinik A Universitätsspital Basel, Switzerland
* Corresponding author. Department of Internal Medicine, Medical Division A, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland. Tel.: +41 0 61 265 2525; fax: +41 49 0 69 13303154027. E-mail address: ChristMic{at}uhbs.ch
 |
Abstract |
|---|
Introduction: We examined whether B-type natriuretic peptide (BNP) levels predict outcome in heart failure patients with implantable cardioverter defibrillators (ICD) using a combined endpoint of malignant tachyarrhythmias, death or heart transplantation.
Methods and results: BNP levels were measured in 123 ICD patients with chronic heart failure (age: 63±12years, ejection fraction: 29±10%). After a median follow-up of 25months, the combined endpoint was reached in 28 patients (first tachyarrhythmic event, n=16; death, n=11; heart transplantation, n=1). BNP levels were significantly lower in patients with event-free survival compared to patients reaching the combined endpoint of this study (median: 140 vs. 373pg/ml; p<0.001). Multivariable Cox regression analysis revealed that BNP levels predict adverse outcome (RR 1.002 per pg/ml increment; 95% CI: 1.001–1.003; p<0.001) and use of beta-blockers was associated with favourable outcome (RR 0.319; 95% CI 0.151–0.670; p=0.004). LV ejection fraction (p=0.66) did not significantly predict event-free survival in multivariable analysis.
Conclusions: BNP plasma levels are useful markers to predict event-free survival in ICD patients with heart failure. Of note, malignant tachyarrhythmias appear responsible for about 50% of fatal outcomes. Our findings suggest that determination of BNP plasma levels is more valuable than determining LV ejection fraction to anticipate event-free survival in this population.
Key Words: Brain natriuretic peptide • Ventricular tachyarrhythmias • Implantable cardioverter defibrillator • Cardiac death • Sudden arrhythmic death
Received January 9, 2006; Revised May 17, 2006; Accepted July 13, 2006
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. M. Kanoupakis, E. G. Manios, and P. E. Vardas Predicting future shocks in implantable cardioverter defibrillator recipients: the role of biomarkers Europace, November 1, 2009; 11(11): 1434 - 1439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Scott, J. Barry, P. R. Roberts, and J. M. Morgan Brain natriuretic peptide for the prediction of sudden cardiac death and ventricular arrhythmias: a meta-analysis Eur J Heart Fail, October 1, 2009; 11(10): 958 - 966. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Mueller The Use of B-Type Natriuretic Peptides in Coronary Artery Disease: Utile or Futile? J. Am. Coll. Cardiol., July 17, 2007; 50(3): 215 - 216. [Full Text] [PDF]
|
|