Preimplantation B-type natriuretic peptide concentration is an independent predictor of future appropriate implantable defibrillator therapies

Verma, A

doi:10.1136/hrt.2004.058198

Cited by 52 publications

(30 citation statements)

References 28 publications

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“…24 In earlier studies, BNP was found as an independent predictor of sudden death in patients with severe LV dysfunction and as an independent predictor of future appropriate ICD therapies in HF patients 12,25 , whereas in the current study BNP was not associated with ventricular tachyarrhythmias during mean follow-up of 5.1 months. In the light of the previous studies, and the mechanoelectric feedback, we attribute our negative results to the stable clinical condition of our patient cohort and to the intermediate-term follow-up duration of the study.…”

Section: Brain Natriuretic Peptidecontrasting

confidence: 56%

Inflammatory Biomarkers are not Predictive of Intermediate‐term Risk of Ventricular Tachyarrhythmias in Stable CHF Patients

Konstantino

Kusniec

Reshef

et al. 2007

Clinical Cardiology

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SummaryBackground: Elevated levels of inflammatory biomarkers and brain natriuretic peptide (BNP) are associated with increased mortality in patients with heart failure (HF).Hypothesis: The aim of the current study was to assess the correlation between circulating biomarkers and ventricular tachyarrhythmias among patients with HF.Methods: Blood samples from 50 stable ambulatory HF patients with moderate to severe systolic left ventricular (LV) dysfunction and an implantable cardioverter defibrillator (ICD) were analyzed for interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hsCRP) and BNP. Thereafter, the patients were followed for a mean period of 152 ± 44 days, during which ventricular tachyarrhythmias were recorded by the ICDs.Results: Follow-up data were obtained from 47 patients. Of them, 45 (96%) had ischemic cardiomyopathy, 38 (81%) had New York Heart Association class I-II, 43 (91%) were males, and the mean age was 68.6 ± 11.1 years. During follow-up, 5 patients (11%) had nonsustained ventricular tachycardia (NSVT), 6 patients (13%) had sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) and 36 patients

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Section: Brain Natriuretic Peptidecontrasting

confidence: 56%

Inflammatory Biomarkers are not Predictive of Intermediate‐term Risk of Ventricular Tachyarrhythmias in Stable CHF Patients

Konstantino

Kusniec

Reshef

et al. 2007

Clinical Cardiology

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“…Several recent studies have examined risk factors for occurrence of appropriate ICD therapies. [7][8][9][10] However, most studies included patients with various underlying cardiac conditions. There are few data providing long-term follow-up of ICD patients exclusively with coronary disease and without limitation of ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapy During Long-Term Follow-up of Patients With Coronary Artery Disease

Blümer¹,

Wölber²,

Hellermann³

et al. 2009

Int. Heart J.

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SummaryIndications for implantable cardioverter defibrillators (ICDs) are expanding. Defining long-term predictors of ICD therapies might help to identify those patients who will benefit most from implantation of an ICD. The objective of this study was to examine longterm predictors of appropriate ICD therapy among patients with coronary disease at high risk of sudden cardiac death.An analysis of 245 patients with coronary disease, who had been implanted with an ICD for primary or secondary prevention of sudden cardiac death, was performed. Time to appropriate ICD therapy, defined as antitachycardia pacing or shock, was evaluated by the Kaplan-Meier method. Cox regression analysis was performed to determine hazard ratios for factors predicting appropriate ICD therapies.During a mean (SD) follow-up of 41 (33) months, 115 patients (53%) experienced appropriate ICD therapy. Independent predictors of appropriate ICD therapy included advanced age, left ventricular ejection fraction (LVEF) < 35%, and impaired renal function, with covariate-adjusted hazard ratios of 1.36 per 10 years (95% CI, 1.11 -1.66; P = 0.003), 1.78 (95% CI, 1.21 -2.63; P = 0.004), and 1.59 (95% CI, 1.00 -2.54; P = 0.050), respectively. Remote myocardial infarction (> 6 months prior to ICD implantation) was associated with higher probability of appropriate ICD therapy among patients with LVEF > 35% (adjusted HR 2.68 [95% CI, 1.05 -6.86; P = 0.04]), but not among patients with LVEF < 35% (adjusted HR 1.09 [95% CI, 0.58 -2.04; P = 0.79]).Left ventricular ejection fraction, advanced age, and renal impairment are long-term predictors of appropriate ICD therapy in patients with coronary disease at high risk of sudden cardiac death. Patients with an ejection fraction above 35% have few arrhythmic events early after the myocardial infarction but appropriate therapies become more frequent late after the myocardial infarction, possibly due to progression of the disease. (Int Heart J 2009; 50: 313-321)

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“…7 -8 Verma et al 8 studied a mixed population of patients (coronary and noncoronary etiologies, primary and secondary prevention) in whom serum BNP levels were taken on the day of ICD implantation. Patients with BNP levels above the 50th percentile (>283 pg/ml) had significantly more events requiring ICD treatment.…”

Section: Discussionmentioning

confidence: 99%

B‐type Natruiretic Peptide Levels Stratify the Risk for Arrhythmia Among Implantable Cardioverter Defibrillator Patients

Galante

Amit

Zahger

et al. 2008

Clinical Cardiology

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Background: We sought to study the association between brain natriuretic peptide (BNP) levels and the occurrence of ventricular arrhythmias in patients with left ventricular dysfunction (LVD) and an implantable cardioverter defibrillator (ICD). Methods: This was a prospective study of consecutive, stable, ambulatory patients with moderate and severe ischemic LVD and an ICD. A plasma BNP level was obtained at recruitment. Patients were evaluated every 3-6 mo for a minimum of 1 y. The primary end point was the occurrence of malignant ventricular arrhythmia or sudden cardiac death (SCD). Results: The cohort consisted of 94 subjects (6 women) with a mean±standard deviation (SD) age of 69±10 y. The ICD implantation indication was primary and secondary prevention of SCD in 49% and 51% of subjects, respectively. A primary end point occurred in 27 patients (29%), and was more frequent in symptomatic heart failure patients and those implanted for secondary prevention of SCD. The median BNP level was significantly higher among patients who experienced an end point (191 pg/ml versus 142 pg/ml, p = 0.03). After controlling for New York Heart Association heart failure class and ICD implantation indication, the odds ratio (OR) for experiencing an adverse outcome among the upper BNP quartile versus all others was 3.5 (95% confidence interval [CI]: 1.2-10.2). Among patients implanted for primary prevention of SCD, none of the patients in the lower BNP quartile (BNP <91 pg/ml) experienced an adverse outcome. Conclusions: These results suggest that abnormally high BNP levels not only predict cardiac death, but also arrhythmic death in this patient population, and a low BNP level can serve to identify low risk patients.

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Preimplantation B-type natriuretic peptide concentration is an independent predictor of future appropriate implantable defibrillator therapies

Abstract: A single preimplantation BNP concentration determination is independently predictive of ICD therapies in patients with cardiomyopathies undergoing first time ICD implantation. CRP was not independently predictive of ICD therapies when compared with BNP.

Cited by 52 publications

References 28 publications

Inflammatory Biomarkers are not Predictive of Intermediate‐term Risk of Ventricular Tachyarrhythmias in Stable CHF Patients

Inflammatory Biomarkers are not Predictive of Intermediate‐term Risk of Ventricular Tachyarrhythmias in Stable CHF Patients

Predictors of Appropriate Implantable Cardioverter-Defibrillator Therapy During Long-Term Follow-up of Patients With Coronary Artery Disease

B‐type Natruiretic Peptide Levels Stratify the Risk for Arrhythmia Among Implantable Cardioverter Defibrillator Patients

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