Cardiac biomarkers for risk stratification of arrhythmic death in patients with heart failure and reduced ejection fraction. Issue 4 (2nd October 2021)

• Record Type: Journal Article
• Authors: Burger, AL; Stojkovic, S; Diedrich, A; Wojta, J; Demyanets, S; Pezawas, T
• Is Part Of: British journal of biomedical science. Volume 78:Issue 4(2021)
• Page Start: 195
• Page End: 200
• Publication Date: 2021-10-02
• Subjects: Sudden cardiac death -- risk stratification -- biomarker -- ventricular tachycardia -- arrhythmic death -- overall mortality; Medical sciences -- Periodicals; Medical technology -- Periodicals; Biological Science Disciplines; Clinical Laboratory Techniques; Medical Laboratory Science; Anatomie pathologique; Medical sciences; Medical technology; Klinische chemie; Laboratoriumonderzoek; Periodicals; Periodicals; 616.0756; 610.07 M489L
• DOI: 10.1080/09674845.2021.1883257
• Languages: English
• ISSNs: 0967-4845

Abstract

ABSTRACT: Objectives . Patients with heart failure and reduced left ventricular ejection fraction (HFrEF) are prone to ventricular tachyarrhythmias. We tested whether biomarkers C-terminal Endothelin 1 (CT-ET1), midregional pro atrial natriuretic peptide (MR-proANP) and midregional pro adrenomedullin (MR-proADM) might improve risk stratification for arrhythmic death. Methods : This prospective observational study included 160 heart failure patients with ischaemic cardiomyopathy (ICM) or non-ischaemic, dilated cardiomyopathy (DCM) and 30 control patients without heart disease. Primary endpoint was arrhythmic death (ArD) or resuscitated cardiac arrest (resCA). Results : A total of 61 patients died during the median follow-up of 7.0 [5.2–8.4] years. An ArD or resCA was observed in 48 patients. Plasma levels of CT-ET1 (p = 0.002), MR-proANP (p < 0.001) and MR-proADM (p = 0.013) were significantly higher in ICM or DCM patients compared to controls. MR-proANP levels in ICM patients were associated with a significantly increased risk for ArD or resCA (hazard ratio (HR) = 1.42, [95%CI: 1.08–1.85], p = 0.011) in a multivariable Cox regression model. Plasma levels of CT-ET1 (HR = 1.07 [0.98–1.17], p = 0.113) and MR-proADM (HR = 1.80 [0.92–3.55], p = 0.087) were not associated with ArD or resCA in ICM patients. No significant association with ArD or resCA was found in DCM patients. Multivariable Cox regression showed that CT-ET1 (HR = 1.14 [1.07–1.22], p < 0.001), MR-proANP (HR = 1.64 [1.29–2.08], p < 0.001) and MR-pro ADM (HR = 2.06 [1.12–3.77], p = 0.020) were associated with a higher risk for overall mortality. Conclusion : Patients with HFrEF had elevated levels of CT-ET1, MR-proANP and MR-proADM. Plasma levels of MR-proANP are useful as predictor for arrhythmic death in patients with ICM.