TY - JOUR
T1 - B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias
AU - Levine, Yehoshua C.
AU - Rosenberg, Michael A.
AU - Mittleman, Murray
AU - Samuel, Michelle
AU - Methachittiphan, Nilubon
AU - Link, Mark
AU - Josephson, Mark E.
AU - Buxton, Alfred E.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2014/7
Y1 - 2014/7
N2 - Background The cost-effective use of implantable cardioverter- defibrillators (ICDs) for the prevention of sudden cardiac death requires identification of patients at risk for ventricular tachyarrhythmias, not just for total mortality. Objective To determine whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) or B-type natriuretic peptide (BNP) are independent predictors of ventricular arrhythmias in patients receiving primary prevention ICDs. Methods One hundred sixty-one patients with NT-proBNP levels and 403 patients with BNP levels at the time of ICD implantation were retrospectively assessed for the occurrence of first appropriate ICD therapy and mortality. Results In multivariable Cox proportional hazards regression analysis, NT-proBNP or BNP levels in the upper 50th percentile were the strongest predictor of ICD therapy after adjustment for sex, age, left ventricular ejection fraction, New York Heart Association class, history of coronary artery disease, blood urea nitrogen, creatinine clearance, and history of atrial fibrillation (hazard ratio [HR] 5.75, P <.001 for NT-proBNP; HR 3.40, P =.01 for BNP). Patients were divided into quartiles on the basis of NT-proBNP or BNP levels. The adjusted HR for ICD therapy in the highest and second highest quartiles of NT-proBNP levels (HR 12.9, P <.001, and HR 4.6, P =.03, respectively) were higher than the adjusted HR for total mortality in these 2 quartiles (HR 3.4, P =.021 and HR 2.3, P =.13, respectively). Similarly, the adjusted HR for ICD therapy in the highest and second highest quartiles of BNP levels (HR 4.74, P =.01 and HR 2.17, P =.04, respectively) were higher than the adjusted HR for total mortality in these 2 quartiles (HR 3.05, P =.01 and HR 1.07, P =.3, respectively). Conclusion In this study, elevated baseline NT-proBNP and BNP levels are independently associated with the risk for ventricular tachyarrhythmias, which significantly exceeds the risk for total mortality, in multivariable analysis.
AB - Background The cost-effective use of implantable cardioverter- defibrillators (ICDs) for the prevention of sudden cardiac death requires identification of patients at risk for ventricular tachyarrhythmias, not just for total mortality. Objective To determine whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) or B-type natriuretic peptide (BNP) are independent predictors of ventricular arrhythmias in patients receiving primary prevention ICDs. Methods One hundred sixty-one patients with NT-proBNP levels and 403 patients with BNP levels at the time of ICD implantation were retrospectively assessed for the occurrence of first appropriate ICD therapy and mortality. Results In multivariable Cox proportional hazards regression analysis, NT-proBNP or BNP levels in the upper 50th percentile were the strongest predictor of ICD therapy after adjustment for sex, age, left ventricular ejection fraction, New York Heart Association class, history of coronary artery disease, blood urea nitrogen, creatinine clearance, and history of atrial fibrillation (hazard ratio [HR] 5.75, P <.001 for NT-proBNP; HR 3.40, P =.01 for BNP). Patients were divided into quartiles on the basis of NT-proBNP or BNP levels. The adjusted HR for ICD therapy in the highest and second highest quartiles of NT-proBNP levels (HR 12.9, P <.001, and HR 4.6, P =.03, respectively) were higher than the adjusted HR for total mortality in these 2 quartiles (HR 3.4, P =.021 and HR 2.3, P =.13, respectively). Similarly, the adjusted HR for ICD therapy in the highest and second highest quartiles of BNP levels (HR 4.74, P =.01 and HR 2.17, P =.04, respectively) were higher than the adjusted HR for total mortality in these 2 quartiles (HR 3.05, P =.01 and HR 1.07, P =.3, respectively). Conclusion In this study, elevated baseline NT-proBNP and BNP levels are independently associated with the risk for ventricular tachyarrhythmias, which significantly exceeds the risk for total mortality, in multivariable analysis.
KW - BNP
KW - ICD
KW - NT-proBNP
KW - Sudden cardiac death
KW - Ventricular arrhythmias
UR - http://www.scopus.com/inward/record.url?scp=84903127341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903127341&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2014.04.024
DO - 10.1016/j.hrthm.2014.04.024
M3 - Article
C2 - 24837348
AN - SCOPUS:84903127341
SN - 1547-5271
VL - 11
SP - 1109
EP - 1116
JO - Heart Rhythm
JF - Heart Rhythm
IS - 7
ER -