NT-proBNP and ICD in Nonischemic Systolic Heart Failure Extended Follow-Up of the DANISH Trial

被引：14

作者：

Butt, Jawad H. ^{[1
]}

Yafasova, Adelina ^{[1
]}

Elming, Marie B. ^{[1
,2
]}

Dixen, Ulrik ^{[3
,4
]}

Nielsen, Jens C. ^{[5
,6
]}

Haarbo, Jens ^{[7
]}

Videbaek, Lars ^{[8
]}

Korup, Eva ^{[9
]}

Bruun, Niels E. ^{[4
,9
,10
,11
]}

Eiskjaer, Hans ^{[5
]}

Brandes, Axel ^{[12
,13
,14
]}

Thogersen, Anna M. ^{[9
]}

Gustafsson, Finn ^{[1
,4
]}

Egstrup, Kenneth ^{[8
]}

Hassager, Christian ^{[1
,4
]}

Svendsen, Jesper Hastrup E. ^{[1
,4
]}

Hofsten, Dan E. ^{[1
,4
,15
]}

Torp-Pedersen, Christian ^{[4
,15
]}

Pehrson, Steen ^{[1
]}

Thune, Jens Jakob ^{[4
,16
]}

Kober, Lars ^{[1
,4
]}

机构：

[1] Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

[2] Zealand Univ Hosp, Dept Internal Med, Roskilde, Denmark

[3] Copenhagen Univ Hosp Amager & Hvidovre, Dept Cardiol, Hvidovre, Denmark

[4] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark

[5] Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark

[6] Aarhus Univ, Dept Clin Med, Aarhus, Denmark

[7] Copenhagen Univ Hosp Herlev & Gentofte, Dept Cardiol, Hellerup, Denmark

[8] Odense Univ Hosp, Dept Cardiol, Svendborg, Denmark

[9] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[10] Zealand Univ Hosp, Dept Cardiol, Roskilde, Denmark

[11] Aalborg Univ, Dept Clin Med, Aalborg, Denmark

[12] Odense Univ Hosp, Dept Cardiol, Odense, Denmark

[13] Univ Southern Denmark, Dept Clin Res, Odense, Denmark

[14] Univ Hosp Southern Denmark, Dept Cardiol, Esbjerg, Denmark

[15] Nordsjaellands Hosp, Dept Cardiol, Hillerod, Denmark

[16] Copenhagen Univ Hosp Bispebjerg & Frederiksberg, Dept Cardiol, Copenhagen, Denmark

来源：

JACC-HEART FAILURE | 2022年 / 10卷 / 03期

关键词：

heart failure; implantable cardioverter-defibrillator; N-termin al pro-B-type natriuretic peptide; mortality; BRAIN NATRIURETIC PEPTIDE; IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; PROGNOSTIC IMPLICATIONS; SUDDEN-DEATH; PREVENTION; SURVIVAL; INSIGHTS; CARE; AGE;

D O I：

10.1016/j.jchf.2022.01.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES In this extended follow-up study of the DANISH (Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with Non-ischemic Systolic Heart Failure on Mortality) trial, adding 4 years of additional follow-up, we examined the effect of implantable cardioverter-defibrillator (ICD) implantation according to baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) level.& nbsp;BACKGROUND In the DANISH trial, NT-proBNP level at baseline appeared to modify the response to ICD implantation.& nbsp;METHODS In the DANISH trial, 1,116 patients with nonischemic systolic HF were randomized to receive an ICD (N = 556) or usual clinical care (N = 550). Outcomes were analyzed according to NT-proBNP levels (below/above median) at baseline. The primary outcome was death from any cause.& nbsp;RESULTS All 1,116 patients in the DANISH trial had an available NT-proBNP measurement at baseline (median: 1,177 pg/mL; range: 200-22,918 pg/mL). There was a trend toward a reduction in all-cause death with ICD implantation, compared with usual clinical care, in patients with NT-proBNP levels lower than the median (HR: 0.75 [95% CI: 0.55-1.03]), but not in those with higher NT-proBNP levels (HR: 0.95 [95% CI: 0.74-1.21]) (P-interaction = 0.28). Similarly, ICD implantation significantly reduced the rate of cardiovascular (CV) and sudden cardiovascular death (SCD) in patients with NT-proBNP levels lower than the median (CV death, HR: 0.69 [95% CI: 0.47-1.00]; SCD, HR: 0.37 [95% CI: 0.19-0.75]), but not in those with higher levels (CV death, HR: 0.94 [95% CI: 0.70-1.25]; SCD, HR: 0.86 [95% CI: 0.49-1.51]) (P-interaction = 0.20 and 0.08 for CV death and SCD, respectively).& nbsp;CONCLUSIONS Lower baseline NT-proBNP levels could identify patients with nonischemic systolic HF who may derive benefit from ICD implantation. (Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with Non-ischemic Systolic Heart Failure on Mortality [DANISH]; NCT00542945) (c) 2022 by the American College of Cardiology Foundation.

引用

页码：161 / 171

页数：11

共 24 条

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