Journal article
B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias
Heart rhythm, v 11(7), pp 1109-1116
01 Jul 2014
PMID: 24837348
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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Details
- Title
- B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias
- Creators
- Yehoshua C. Levine - Beth Israel Deaconess Medical CenterMichael A. Rosenberg - VA Boston Healthcare SystemMurray Mittleman - Beth Israel Deaconess Medical CenterMichelle Samuel - Beth Israel Deaconess Medical CenterNilubon Methachittiphan - Tufts Medical CenterMark Link - Tufts Medical CenterMark E. Josephson - Beth Israel Deaconess Medical CenterAlfred E. Buxton - Beth Israel Deaconess Medical Center
- Publication Details
- Heart rhythm, v 11(7), pp 1109-1116
- Publisher
- Elsevier
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000341435900005
- Scopus ID
- 2-s2.0-84903127341
- Other Identifier
- 991022135636404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems