B-Type Natriuretic Peptide Predicts Sudden Death in Patients With Chronic Heart Failure

Autor: Anja Bojic, Karin Strecker, Brigitte Stanek, Rudolf Berger, Richard Pacher, Petra Moser, Martin Huelsman
Rok vydání: 2002
Předmět:
Male
medicine.hormone
medicine.medical_specialty
Cardiotonic Agents
Heart disease
medicine.drug_class
medicine.medical_treatment
Adrenergic beta-Antagonists
Angiotensin-Converting Enzyme Inhibitors
Enzyme-Linked Immunosorbent Assay
Comorbidity
Sudden death
Endothelins
Predictive Value of Tests
Risk Factors
Physiology (medical)
Internal medicine
Natriuretic Peptide
Brain
Natriuretic peptide
medicine
Humans
Alprostadil
Protein Precursors
Heart Failure
Heart transplantation
Ejection fraction
Endothelin-1
business.industry
Arrhythmias
Cardiac
Stroke Volume
Middle Aged
Prognosis
medicine.disease
Brain natriuretic peptide
Survival Analysis
Death
Sudden
Cardiac
Treatment Outcome
Heart failure
Chronic Disease
Multivariate Analysis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Atrial Natriuretic Factor
Zdroj: Circulation. 105:2392-2397
ISSN: 1524-4539
0009-7322
Popis: Background — Given the high incidence of sudden death in patients with chronic heart failure (CHF) and the efficacy of implantable cardioverter-defibrillators, an appropriate tool for the prediction of sudden death is desirable. B-type natriuretic peptide (BNP) has prognostic significance in CHF, and the stimuli for its production cause electrophysiological abnormalities. This study tests BNP levels as a predictor of sudden death. Methods and Results — BNP levels, in addition to other neurohormonal, clinical, and hemodynamic variables, were obtained from 452 patients with a left ventricular ejection fraction (LVEF) ≤35%. For prediction of sudden death, only survivors without heart transplantation (HTx) or a mechanical assist device and patients who died suddenly were analyzed. Up to 3 years, 293 patients survived without HTx or a mechanical assist device, 89 patients died, and 65 patients underwent HTx. Mode of death was sudden in 44 patients (49%), whereas 31 patients (35%) had pump failure and 14 patients (16%) died from other causes. Univariate risk factors of sudden death were log BNP ( P =0.0006), log N-terminal atrial natriuretic peptide ( P =0.003), LVEF ( P =0.005), log N-terminal BNP ( P =0.006), systolic blood pressure ( P =0.01), big endothelin ( P =0.03), and NYHA class ( P =0.04). In the multivariate model, log BNP level was the only independent predictor of sudden death ( P =0.0006). Using a cutoff point of log BNP P =0.0001). Conclusion — BNP levels are a strong, independent predictor of sudden death in patients with CHF.
Databáze: OpenAIRE
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