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Prognostic role of high-sensitivity C-reactive protein and B-type natriuretic peptide in implantable cardioverter-defibrillator patients

Author
Organization
Abstract
Background: High-sensitivity C-reactive protein (hs-CRP) and B-type natriuretic peptide (BNP) are useful biomarkers for cardiovascular risk stratification. Little data are available regarding the prognostic value of hs-CRP and BNP serum levels and future ventricular arrhythmic events triggering implantable cardioverter defibrillator (ICD) therapy. Methods: A total of 100 patients eligible for ICD implantation were enrolled in a prospective cohort study. Serum levels of hs-CRP and BNP were obtained the day before ICD implantation and at scheduled follow-up visits. For risk analysis, the study cohort was dichotomized based on serum level of hs-CRP using a cut-off value of 3 mg/L. The endpoint was appropriate ICD therapy triggered by ventricular arrhythmias during a follow-up of 24 months. Results: Appropriate ICD therapy was delivered in 20% of patients. Median baseline serum level of hsCRP was significantly higher in patients with appropriate ICD therapy than in those without appropriate ICD therapy (5.33 mg/L vs 2.19 mg/L; P = 0.002). The same was true for median serum levels of hs-CRP and BNP during follow-up (5.43 mg/L vs 2.61 mg/L, P = 0.001 and 261.0 pg/mL vs 80.1 pg/mL, P = 0.01, respectively). Multivariate analysis demonstrated that baseline hs-CRP level > 3 mg/L was independently associated with appropriate ICD therapy (odds ratio 4.0, 95% 1.1-14.2; P = 0.03). Conclusion: Elevated preimplantation hs-CRP serum level is independently associated with increased risk for appropriate ICD therapy. Monitoring for elevated BNP levels during follow-up adds to the assessment of risk for future arrhythmias.
Keywords
B-type natriuretic peptide, implantable cardioverter-defibrillator, high-sensitivity C-reactive protein, inflammation, ventricular arrhythmia, CONGESTIVE-HEART-FAILURE, LIPID-LOWERING DRUGS, SUDDEN CARDIAC DEATH, MYOCARDIAL-INFARCTION, VENTRICULAR-ARRHYTHMIAS, CARDIOVASCULAR-DISEASE, ATRIAL-FIBRILLATION, NONISCHEMIC CARDIOMYOPATHY, ICD-RECIPIENTS, RISK

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MLA
Theuns, Dominic AMJ et al. “Prognostic Role of High-sensitivity C-reactive Protein and B-type Natriuretic Peptide in Implantable Cardioverter-defibrillator Patients.” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 35.3 (2012): 275–282. Print.
APA
Theuns, D. A., Smith, T., Szili-Torok, T., Muskens-Heemskerk, A., Janse, P., & Jordaens, L. (2012). Prognostic role of high-sensitivity C-reactive protein and B-type natriuretic peptide in implantable cardioverter-defibrillator patients. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 35(3), 275–282.
Chicago author-date
Theuns, Dominic AMJ, Tim Smith, Tamas Szili-Torok, Agnes Muskens-Heemskerk, Petter Janse, and Luc Jordaens. 2012. “Prognostic Role of High-sensitivity C-reactive Protein and B-type Natriuretic Peptide in Implantable Cardioverter-defibrillator Patients.” Pace-pacing and Clinical Electrophysiology 35 (3): 275–282.
Chicago author-date (all authors)
Theuns, Dominic AMJ, Tim Smith, Tamas Szili-Torok, Agnes Muskens-Heemskerk, Petter Janse, and Luc Jordaens. 2012. “Prognostic Role of High-sensitivity C-reactive Protein and B-type Natriuretic Peptide in Implantable Cardioverter-defibrillator Patients.” Pace-pacing and Clinical Electrophysiology 35 (3): 275–282.
Vancouver
1.
Theuns DA, Smith T, Szili-Torok T, Muskens-Heemskerk A, Janse P, Jordaens L. Prognostic role of high-sensitivity C-reactive protein and B-type natriuretic peptide in implantable cardioverter-defibrillator patients. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY. 2012;35(3):275–82.
IEEE
[1]
D. A. Theuns, T. Smith, T. Szili-Torok, A. Muskens-Heemskerk, P. Janse, and L. Jordaens, “Prognostic role of high-sensitivity C-reactive protein and B-type natriuretic peptide in implantable cardioverter-defibrillator patients,” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, vol. 35, no. 3, pp. 275–282, 2012.
@article{8101411,
  abstract     = {Background: High-sensitivity C-reactive protein (hs-CRP) and B-type natriuretic peptide (BNP) are useful biomarkers for cardiovascular risk stratification. Little data are available regarding the prognostic value of hs-CRP and BNP serum levels and future ventricular arrhythmic events triggering implantable cardioverter defibrillator (ICD) therapy. 
Methods: A total of 100 patients eligible for ICD implantation were enrolled in a prospective cohort study. Serum levels of hs-CRP and BNP were obtained the day before ICD implantation and at scheduled follow-up visits. For risk analysis, the study cohort was dichotomized based on serum level of hs-CRP using a cut-off value of 3 mg/L. The endpoint was appropriate ICD therapy triggered by ventricular arrhythmias during a follow-up of 24 months. 
Results: Appropriate ICD therapy was delivered in 20% of patients. Median baseline serum level of hsCRP was significantly higher in patients with appropriate ICD therapy than in those without appropriate ICD therapy (5.33 mg/L vs 2.19 mg/L; P = 0.002). The same was true for median serum levels of hs-CRP and BNP during follow-up (5.43 mg/L vs 2.61 mg/L, P = 0.001 and 261.0 pg/mL vs 80.1 pg/mL, P = 0.01, respectively). Multivariate analysis demonstrated that baseline hs-CRP level > 3 mg/L was independently associated with appropriate ICD therapy (odds ratio 4.0, 95% 1.1-14.2; P = 0.03). 
Conclusion: Elevated preimplantation hs-CRP serum level is independently associated with increased risk for appropriate ICD therapy. Monitoring for elevated BNP levels during follow-up adds to the assessment of risk for future arrhythmias.},
  author       = {Theuns, Dominic AMJ and Smith, Tim and Szili-Torok, Tamas and Muskens-Heemskerk, Agnes and Janse, Petter and Jordaens, Luc},
  issn         = {0147-8389},
  journal      = {PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY},
  keywords     = {B-type natriuretic peptide,implantable cardioverter-defibrillator,high-sensitivity C-reactive protein,inflammation,ventricular arrhythmia,CONGESTIVE-HEART-FAILURE,LIPID-LOWERING DRUGS,SUDDEN CARDIAC DEATH,MYOCARDIAL-INFARCTION,VENTRICULAR-ARRHYTHMIAS,CARDIOVASCULAR-DISEASE,ATRIAL-FIBRILLATION,NONISCHEMIC CARDIOMYOPATHY,ICD-RECIPIENTS,RISK},
  language     = {eng},
  number       = {3},
  pages        = {275--282},
  title        = {Prognostic role of high-sensitivity C-reactive protein and B-type natriuretic peptide in implantable cardioverter-defibrillator patients},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2011.03289.x},
  volume       = {35},
  year         = {2012},
}

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