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B‐type natriuretic peptide levels predict event‐free survival in patients with implantable cardioverter defibrillators
Author(s) -
Christ Michael,
Sharkova Julia,
Bayrakcioglu Somer,
Herzum Ileana,
Mueller Christian,
Grimm Wolfram
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.07.004
Subject(s) - medicine , natriuretic peptide , heart failure , cardiology , implantable cardioverter defibrillator
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.