1. N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy.
- Author
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Wu G, Liu J, Wang S, Yu S, Zhang C, Wang D, Zhang M, Yang Y, Kang L, Zhao S, Hui R, Zou Y, Wang J, and Song L
- Subjects
- Beijing epidemiology, Biomarkers blood, Cardiomyopathy, Hypertrophic complications, Death, Sudden, Cardiac epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Protein Precursors, Risk Factors, Survival Rate trends, Time Factors, Cardiomyopathy, Hypertrophic blood, Death, Sudden, Cardiac etiology, Natriuretic Peptide, Brain blood, Peptide Fragments blood
- Abstract
Objective: Elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with heart failure-related death in hypertrophic cardiomyopathy (HCM), but the relationship between NT-proBNP level and sudden cardiac death (SCD) in HCM remains undefined., Methods: The study prospectively enrolled 977 unrelated patients with HCM with available NT-proBNP results who were prospectively enrolled and followed for 3.0±2.1 years. The Harrell's C-statistic under the receiver operating characteristic curve was calculated to evaluate discrimination performance. A combination model was constructed by adding NT-proBNP tertiles to the HCM Risk-SCD model. The correlation between log NT-proBNP level and cardiac fibrosis as measured by late gadolinium enhancement (LGE) or Masson's staining was analysed., Results: During follow-up, 29 patients had SCD. Increased log NT-proBNP levels were associated with an increased risk of SCD events (adjusted HR 22.27, 95% CI 10.93 to 65.63, p<0.001). The C-statistic of NT-proBNP in predicting SCD events was 0.80 (p<0.001). The combined model significantly improved the predictive efficiency of the HCM Risk-SCD model from 0.72 to 0.81 (p<0.05), with a relative integrated discrimination improvement of 0.002 (p<0.001) and net reclassification improvement of 0.67 (p<0.001). Furthermore, log NT-proBNP levels were significantly correlated with cardiac fibrosis as detected either by LGE (r=0.257, p<0.001) or by Masson's trichrome staining in the myocardium (r=0.198, p<0.05)., Conclusion: NT-proBNP is an independent predictor of SCD in patients with HCM and may help with risk stratification of this disease., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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