Author's Accepted Manuscript
B-type Natriuretic Peptide is a Major Predictor of Ventricular Tachyarrhythmias Yehoshua C. Levine MD, Michael A. Rosenberg MD, Murray Mittleman MD, DrPH, Michelle Samuel BA, Nilubon Methachittiphan MD, Mark Link MD, Mark E. Josephson MD, Alfred E. Buxton MD
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PII: DOI: Reference:
S1547-5271(14)00452-4 http://dx.doi.org/10.1016/j.hrthm.2014.04.024 HRTHM5745
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Heart Rhythm
Cite this article as: Yehoshua C. Levine MD, Michael A. Rosenberg MD, Murray Mittleman MD, DrPH, Michelle Samuel BA, Nilubon Methachittiphan MD, Mark Link MD, Mark E. Josephson MD, Alfred E. Buxton MD, B-type Natriuretic Peptide is a Major Predictor of Ventricular Tachyarrhythmias, Heart Rhythm, http://dx.doi.org/ 10.1016/j.hrthm.2014.04.024 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
B-type Natriuretic Peptide is a Major Predictor of Ventricular Tachyarrhythmias Yehoshua C. Levine, MD1; Michael A. Rosenberg, MD2; Murray Mittleman, MD, DrPH1; Michelle Samuel, BA1; Nilubon Methachittiphan, MD3; Mark Link, MD3; Mark E. Josephson, MD1; Alfred E. Buxton, MD1
1
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
2
VA Boston Healthcare System, Boston, MA
3
Tufts Medical Center, Boston, MA
Conflicts of interest and sources of financial support are detailed in the Conflict of Interest Statement, attached separately. The co-authors have no sources of financial support or conflicts of interest to disclose.
Short running title: BNP predicts ICD therapies Word count (includes abstract, references, tables, figure legends): 5286
Address correspondence to: Alfred E. Buxton, MD Beth Israel Deaconess Medical Center, Baker 4 185 Pilgrim Road Boston, MA 02215 Phone: 617-667-880 Fax: 617-667-1753 Email address:
[email protected]
1
Abstract:
Background: Cost-effective use of ICDs for prevention of sudden cardiac
death requires identification of patients at risk for ventricular tachyarrhythmias, not just total mortality. Objective: To determine whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) or B-type natriuretic peptide (BNP) are independent predictors of ventricular arrhythmias in patients receiving primary prevention ICDs. Methods: 161 patients with NT-proBNP values and 403 patients with BNP values at the time of ICD implantation were retrospectively assessed for occurrence of first appropriate ICD therapy and mortality. Results: In multivariable Cox regression analysis, NT-proBNP or BNP values in the upper 50th percentile were the strongest predictor of ICD therapy after adjustment for sex, age, LVEF, NYHA class, CAD, BUN, creatinine clearance, and AF (HR 5.75, p
