Document Detail


Relationships between cardiac resynchronization therapy and N-terminal pro-brain natriuretic peptide in patients with heart failure and markers of cardiac dyssynchrony: an analysis from the Cardiac Resynchronization in Heart Failure (CARE-HF) study.
MedLine Citation:
PMID:  19493864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The Cardiac Resynchronization in Heart Failure (CARE-HF) study showed that cardiac resynchronization therapy (CRT) reduces mortality in HF patients with markers of dyssynchrony. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) might predict which patients benefit most from CRT. We evaluated whether the prognostic value of NT-proBNP was influenced by CRT and the effects of CRT stratified according to NT-proBNP.
METHODS AND RESULTS: A total of 813 patients were enrolled in CARE-HF. Baseline log-transformed NT-proBNP independently predicted all-cause mortality, sudden death, and death from pump failure. In a multivariable model including log-transformed NT-proBNP, assignment to CRT remained independently associated with better prognosis without evidence of interaction. Stratifying patients according to the median NT-proBNP and to CRT treatment allocation, all-cause mortality was 12% if <median + CRT, 25% if <median + control group, 35% if >or= median + CRT, and 51% if >or= median + control group. There was no evidence of a difference in the relative effect of CRT across different values of NT-proBNP. Conclusion: NT-proBNP retains its prognostic value in HF patients with CRT. Deploying CRT before the patients have reached end-stage HF may maximize the benefit of treatment.
Authors:
Rudolf Berger; Aparna Shankar; Friedrich Fruhwald; Astrid Fahrleitner-Pammer; Nick Freemantle; Luigi Tavazzi; John G F Cleland; Richard Pacher
Related Documents :
21546274 - Altered melusin pathways involved in cardiac remodeling following acute myocardial infa...
21686364 - An unusual case of infective endocarditis presenting as acute myocardial infarction.
21343484 - Irreversible electroporation near the heart: ventricular arrhythmias can be prevented w...
17883994 - Assessment of quality of life in severe heart failure.
2686834 - The effect of hypodynamic endotoxin shock on myocardial high energy phosphates in the rat.
10892924 - Minimally invasive coronary artery revascularization on the beating heart.
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-06-02
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-02     Completed Date:  2010-06-18     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2109-16     Citation Subset:  IM    
Affiliation:
Department of Cardiology, General Hospital of St Pölten, St Pölten, Austria. rudolf.berger@meduniwien.ac.at
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Arrhythmias, Cardiac / blood,  therapy*
Biological Markers / metabolism
Cardiac Pacing, Artificial*
Diuretics / therapeutic use
Female
Heart Failure / blood,  therapy*
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Natriuretic Peptide, Brain / metabolism*
Peptide Fragments / metabolism*
Spironolactone / therapeutic use
Treatment Outcome
Ventricular Dysfunction, Left / therapy*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Diuretics; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 52-01-7/Spironolactone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Assessment of organizational readiness for health promotion policy implementation: test of a theoret...
Next Document:  Recurrence of ventricular arrhythmias in ischaemic secondary prevention implantable cardioverter def...