The University of Southampton
University of Southampton Institutional Repository

Defining potential to benefit from implantable cardioverter defibrillator therapy: the role of biomarkers

Record type: Article

Aims: Implantable cardioverter defibrillator (ICD) therapy improves survival in patients at high sudden cardiac death (SCD) risk. However, some patient groups fulfilling indications for ICD therapy may not gain significant benefit: patients whose absolute risk of SCD is low and patients whose risk of death even with an ICD is high. The value of biomarkers in identifying patients’ potential for survival benefit from ICD therapy is unknown. We performed a pilot study to investigate this.

Methods and results: Five established cardiovascular biomarkers were measured in patients with ICDs on the background of left ventricular dysfunction: N-terminal pro-brain natriuretic peptide [NT-proBNP], soluble ST2 [sST2], growth differentiation factor-15, C-reactive protein, and interleukin-6. The endpoints were all-cause mortality and survival with appropriate ICD therapy. One hundred and fifty-six patients were enrolled (age 69 years [Q1–Q3 62–77], 85% male, 76% ischaemic aetiology). During a follow-up of 15 ± 3 months, 12 patients died and 43 survived with appropriate ICD therapy. In a Cox proportional hazards model, the strongest predictors of death were Log sST2 (P< 0.001), serum creatinine (P< 0.001), and Log NT-proBNP (P= 0.002). The strongest predictor of survival with appropriate ICD therapy was Log NT-proBNP (P= 0.01).

Conclusion: The biomarkers NT-proBNP and sST2 are promising biomarkers for identifying patients with little potential to gain significant survival benefit from ICD therapy. However, their incremental benefit, in addition to currently available clinical risk prediction models, remains unclear. These results demand a confirmatory prospective cohort study, designed and powered to derive and validate prediction algorithms incorporating these markers.

Full text not available from this repository.

Citation

Scott, Paul A., Townsend, Paul A., Ng, Leong L., Zeb, Mehmood, Harris, Scott, Roderick, Paul J., Curzen, Nick P. and Morgan, John M. (2011) Defining potential to benefit from implantable cardioverter defibrillator therapy: the role of biomarkers Europace, 13, (10), pp. 1419-1427. (doi:10.1093/europace/eur147). (PMID:21784745).

More information

Accepted/In Press date: 21 July 2011
Published date: October 2011
Keywords: implantable cardioverter defibrillators, heart failure, biomarkers, mortality, arrhythmias
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 194395
URI: http://eprints.soton.ac.uk/id/eprint/194395
ISSN: 1099-5129
PURE UUID: ab29c864-c4dd-4e81-a30e-3f8a9f1b6f90
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 27 Jul 2011 12:58
Last modified: 18 Jul 2017 11:27

Export record

Altmetrics


Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×