NT-proBNP and ICD in Nonischemic Systolic Heart Failure: Extended Follow-Up of the DANISH Trial
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NT-proBNP and ICD in Nonischemic Systolic Heart Failure : Extended Follow-Up of the DANISH Trial. / Butt, Jawad H.; Yafasova, Adelina; Elming, Marie B.; Dixen, Ulrik; Nielsen, Jens C.; Haarbo, Jens; Videbæk, Lars; Korup, Eva; Bruun, Niels E.; Eiskjær, Hans; Brandes, Axel; Thøgersen, Anna M.; Gustafsson, Finn; Egstrup, Kenneth; Hassager, Christian; Svendsen, Jesper Hastrup; Høfsten, Dan E.; Torp-Pedersen, Christian; Pehrson, Steen; Thune, Jens Jakob; Køber, Lars.
I: JACC: Heart Failure, Bind 10, Nr. 3, 2022, s. 161-171.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - NT-proBNP and ICD in Nonischemic Systolic Heart Failure
T2 - Extended Follow-Up of the DANISH Trial
AU - Butt, Jawad H.
AU - Yafasova, Adelina
AU - Elming, Marie B.
AU - Dixen, Ulrik
AU - Nielsen, Jens C.
AU - Haarbo, Jens
AU - Videbæk, Lars
AU - Korup, Eva
AU - Bruun, Niels E.
AU - Eiskjær, Hans
AU - Brandes, Axel
AU - Thøgersen, Anna M.
AU - Gustafsson, Finn
AU - Egstrup, Kenneth
AU - Hassager, Christian
AU - Svendsen, Jesper Hastrup
AU - Høfsten, Dan E.
AU - Torp-Pedersen, Christian
AU - Pehrson, Steen
AU - Thune, Jens Jakob
AU - Køber, Lars
N1 - Publisher Copyright: © 2022 American College of Cardiology Foundation
PY - 2022
Y1 - 2022
N2 - 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]) (Pinteraction = 0.28). Similarly, ICD implantation significantly reduced the rate of cardiovascular (CV) and sudden cardiovascular death (SCD) in patients with NT-proBNP levels lower than the median (CV death, HR: 0.69 [95% CI: 0.47-1.00]; SCD, HR: 0.37 [95% CI: 0.19-0.75]), but not in those with higher levels (CV death, HR: 0.94 [95% CI: 0.70-1.25]; SCD, HR: 0.86 [95% CI: 0.49-1.51]) (Pinteraction = 0.20 and 0.08 for CV death and SCD, respectively). 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)
AB - 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]) (Pinteraction = 0.28). Similarly, ICD implantation significantly reduced the rate of cardiovascular (CV) and sudden cardiovascular death (SCD) in patients with NT-proBNP levels lower than the median (CV death, HR: 0.69 [95% CI: 0.47-1.00]; SCD, HR: 0.37 [95% CI: 0.19-0.75]), but not in those with higher levels (CV death, HR: 0.94 [95% CI: 0.70-1.25]; SCD, HR: 0.86 [95% CI: 0.49-1.51]) (Pinteraction = 0.20 and 0.08 for CV death and SCD, respectively). 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)
KW - heart failure
KW - implantable cardioverter-defibrillator
KW - mortality
KW - N-terminal pro–B-type natriuretic peptide
U2 - 10.1016/j.jchf.2022.01.003
DO - 10.1016/j.jchf.2022.01.003
M3 - Journal article
C2 - 35241243
AN - SCOPUS:85124773259
VL - 10
SP - 161
EP - 171
JO - J A C C: Heart Failure
JF - J A C C: Heart Failure
SN - 2213-1779
IS - 3
ER -
ID: 320762061