NT-proBNP and ICD in Nonischemic Systolic Heart Failure: Extended Follow-Up of the DANISH Trial.
N-terminal pro–B-type natriuretic peptide
heart failure
implantable cardioverter-defibrillator
mortality
Journal
JACC. Heart failure
ISSN: 2213-1787
Titre abrégé: JACC Heart Fail
Pays: United States
ID NLM: 101598241
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
01
11
2021
revised:
30
12
2021
accepted:
03
01
2022
entrez:
4
3
2022
pubmed:
5
3
2022
medline:
30
4
2022
Statut:
ppublish
Résumé
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. In the DANISH trial, NT-proBNP level at baseline appeared to modify the response to ICD implantation. 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. 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]) (P 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).
Sections du résumé
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]) (P
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).
Identifiants
pubmed: 35241243
pii: S2213-1779(22)00058-0
doi: 10.1016/j.jchf.2022.01.003
pii:
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Banques de données
ClinicalTrials.gov
['NCT00542945']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
161-171Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Funding Support and Author Disclosures Dr Butt has received advisory board honoraria from Bayer, outside the submitted work. Dr Nielsen is supported by a grant from the Novo Nordisk Foundation (NNF16OC0018658) outside this work. Dr Bruun has received funding from the Novo Nordisk Foundation, the Augustinus Foundation, the Kaj Hansen Foundation, and from Health Insurance Denmark outside this work. Dr Brandes has received a research grant from Theravance and the Regions of Southern Denmark and Zealand; has received speaker honoraria from Bayer, Boehringer Ingelheim, and Bristol-Myers Squibb; and has received a travel grant from Biotronik outside this work. Dr Gustafsson has received speaker honorarium from Orion, Novartis, and Vifor Pharma; and has received advisory board honorarium from Abott, Bayer, Alnylam, Ionis, Pfizer, Corvia, and Pharmacosmos. Dr Hassager has received speaker honorarium from Abiomed. Dr Svendsen has received speaker honorarium from Medtronic. Dr Pehrson has received lecture fees from Abbott, Bristol Myers Squibb, and AstraZeneca. Dr Køber has received speaker honorarium from Novartis, AstraZeneca, Boehringer, and Novo Nordisk. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.