Financial Support: The study was supported by an unrestricted research grant by St. Jude Medical (Veenendaal, The Netherlands).
Prognostic Role of High-Sensitivity C-Reactive Protein and B-Type Natriuretic Peptide in Implantable Cardioverter-Defibrillator Patients
Article first published online: 8 DEC 2011
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 35, Issue 3, pages 275–282, March 2012
How to Cite
THEUNS, D. A. M. J., SMITH, T., SZILI-TOROK, T., MUSKENS-HEEMSKERK, R. N., A., JANSE, P. and JORDAENS, L. (2012), Prognostic Role of High-Sensitivity C-Reactive Protein and B-Type Natriuretic Peptide in Implantable Cardioverter-Defibrillator Patients. Pacing and Clinical Electrophysiology, 35: 275–282. doi: 10.1111/j.1540-8159.2011.03289.x
- Issue published online: 5 MAR 2012
- Article first published online: 8 DEC 2011
- Received April 26, 2011; revised September 15, 2011; accepted September 25, 2011.
- high-sensitivity C-reactive protein;
- B-type natriuretic peptide;
- implantable cardioverter-defibrillator;
- ventricular arrhythmia
Background:High-sensitivity C-reactive protein (hs-CRP) and B-type natriuretic peptide (BNP) are useful biomarkers for cardiovascular risk stratification. Little data are available regarding the prognostic value of hs-CRP and BNP serum levels and future ventricular arrhythmic events triggering implantable cardioverter defibrillator (ICD) therapy.
Methods:A total of 100 patients eligible for ICD implantation were enrolled in a prospective cohort study. Serum levels of hs-CRP and BNP were obtained the day before ICD implantation and at scheduled follow-up visits. For risk analysis, the study cohort was dichotomized based on serum level of hs-CRP using a cut-off value of 3 mg/L. The endpoint was appropriate ICD therapy triggered by ventricular arrhythmias during a follow-up of 24 months.
Results:Appropriate ICD therapy was delivered in 20% of patients. Median baseline serum level of hs-CRP was significantly higher in patients with appropriate ICD therapy than in those without appropriate ICD therapy (5.33 mg/L vs 2.19 mg/L; P = 0.002). The same was true for median serum levels of hs-CRP and BNP during follow-up (5.43 mg/L vs 2.61 mg/L, P = 0.001 and 261.0 pg/mL vs 80.1 pg/mL, P = 0.01, respectively). Multivariate analysis demonstrated that baseline hs-CRP level > 3 mg/L was independently associated with appropriate ICD therapy (odds ratio 4.0, 95% 1.1–14.2; P = 0.03).
Conclusion:Elevated preimplantation hs-CRP serum level is independently associated with increased risk for appropriate ICD therapy. Monitoring for elevated BNP levels during follow-up adds to the assessment of risk for future arrhythmias. (PACE 2011;1–8)