B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias

Yehoshua Levine, Michael A. Rosenberg, Murray Mittleman, Michelle Samuel, Nilubon Methachittiphan, Mark Link, Mark E. Josephson, Alfred E. Buxton

Research output: Contribution to journalArticle

33 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1109-1116
Number of pages8
JournalHeart Rhythm
Volume11
Issue number7
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Brain Natriuretic Peptide
Tachycardia
Implantable Defibrillators
Mortality
Blood Urea Nitrogen
Sudden Cardiac Death
Primary Prevention
Therapeutics
Stroke Volume
Atrial Fibrillation
Cardiac Arrhythmias
Coronary Artery Disease
Creatinine

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Levine, Y., Rosenberg, M. A., Mittleman, M., Samuel, M., Methachittiphan, N., Link, M., ... Buxton, A. E. (2014). B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias. Heart Rhythm, 11(7), 1109-1116. https://doi.org/10.1016/j.hrthm.2014.04.024

B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias. / Levine, Yehoshua; Rosenberg, Michael A.; Mittleman, Murray; Samuel, Michelle; Methachittiphan, Nilubon; Link, Mark; Josephson, Mark E.; Buxton, Alfred E.

In: Heart Rhythm, Vol. 11, No. 7, 01.01.2014, p. 1109-1116.

Research output: Contribution to journalArticle

Levine, Y, Rosenberg, MA, Mittleman, M, Samuel, M, Methachittiphan, N, Link, M, Josephson, ME & Buxton, AE 2014, 'B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias', Heart Rhythm, vol. 11, no. 7, pp. 1109-1116. https://doi.org/10.1016/j.hrthm.2014.04.024
Levine Y, Rosenberg MA, Mittleman M, Samuel M, Methachittiphan N, Link M et al. B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias. Heart Rhythm. 2014 Jan 1;11(7):1109-1116. https://doi.org/10.1016/j.hrthm.2014.04.024
Levine, Yehoshua ; Rosenberg, Michael A. ; Mittleman, Murray ; Samuel, Michelle ; Methachittiphan, Nilubon ; Link, Mark ; Josephson, Mark E. ; Buxton, Alfred E. / B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias. In: Heart Rhythm. 2014 ; Vol. 11, No. 7. pp. 1109-1116.
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T1 - B-type natriuretic peptide is a major predictor of ventricular tachyarrhythmias

AU - Levine, Yehoshua

AU - Rosenberg, Michael A.

AU - Mittleman, Murray

AU - Samuel, Michelle

AU - Methachittiphan, Nilubon

AU - Link, Mark

AU - Josephson, Mark E.

AU - Buxton, Alfred E.

PY - 2014/1/1

Y1 - 2014/1/1

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.

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