TY - JOUR
T1 - NT-proBNP and ICD in Nonischemic Systolic Heart Failure
T2 - Extended Follow-Up of the DANISH Trial
AU - Butt, Jawad H
AU - Yafasova, Adelina
AU - Elming, Marie B
AU - Dixen, Ulrik
AU - Nielsen, Jens C
AU - Haarbo, Jens
AU - Videbæk, Lars
AU - Korup, Eva
AU - Bruun, Niels E
AU - Eiskjær, Hans
AU - Brandes, Axel
AU - Thøgersen, Anna M
AU - Gustafsson, Finn
AU - Egstrup, Kenneth
AU - Hassager, Christian
AU - Svendsen, Jesper Hastrup
AU - Høfsten, Dan E
AU - Torp-Pedersen, Christian
AU - Pehrson, Steen
AU - Thune, Jens Jakob
AU - Køber, Lars
N1 - Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - 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.BACKGROUND: In the DANISH trial, NT-proBNP level at baseline appeared to modify the response to ICD implantation.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.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]) (Pinteraction = 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]) (Pinteraction = 0.20 and 0.08 for CV death and SCD, respectively).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).
AB - 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.BACKGROUND: In the DANISH trial, NT-proBNP level at baseline appeared to modify the response to ICD implantation.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.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]) (Pinteraction = 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]) (Pinteraction = 0.20 and 0.08 for CV death and SCD, respectively).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).
KW - Biomarkers
KW - Death, Sudden, Cardiac/epidemiology
KW - Defibrillators, Implantable
KW - Denmark/epidemiology
KW - Follow-Up Studies
KW - Heart Failure, Systolic/complications
KW - Heart Failure/complications
KW - Humans
KW - Natriuretic Peptide, Brain
KW - Peptide Fragments
UR - http://www.scopus.com/inward/record.url?scp=85124773259&partnerID=8YFLogxK
U2 - 10.1016/j.jchf.2022.01.003
DO - 10.1016/j.jchf.2022.01.003
M3 - Journal article
C2 - 35241243
SN - 2213-1779
VL - 10
SP - 161
EP - 171
JO - JACC. Heart failure
JF - JACC. Heart failure
IS - 3
ER -