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Pro-BNP variation as a risk marker of Ventricular arrythmias in CRT patients
Session:
SESSÃO DE POSTERS 42 - DISPOSITIVOS CARDÍACOS IMPLANTÁVEIS: CDI E CRT
Speaker:
Luís Sousa Azevedo
Congress:
CPC 2025
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.7 Ventricular Arrhythmias and SCD - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Luís Sousa Azevedo; Marta Bernardo; Isabel Martins Moreira; Isabel Nóbrega Fernandes; José Pedro Guimarães; Renato Margato; Paulo Fontes; Sílvia Leão; Ilídio Moreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction: </strong>Pro-brain natriuretic peptide (pro-BNP) is a biomarker associated with cardiovascular disease and is commonly elevated in patients with heart failure, particularly during acute events.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Objectives:</strong> This study aimed to evaluate whether changes in pro-BNP levels after Cardiac Resynchronization Therapy (CRT) are related to the risk of developing ventricular arrhythmias.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>This observational retrospective study included patients who underwent CRT device implantation between January 2017 and March 2024. From a total population of 201 patients, we included all those who met the evaluation criteria for this study, specifically having pro-BNP measurements taken before CRT device implantation and at the one-year follow-up. Patients were categorized into two groups based on their pro-BNP variation during follow-up, calculated as the difference between pro-BNP levels measured before implantation and at the 1-year follow-up. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">Group differences were assessed using the Chi-square test or the median comparison test, as appropriate. Survival analysis was conducted using Cox regression, adjusted for potential confounding factors, with the occurrence of sustained ventricular arrhythmias (defined as ventricular fibrillation or ventricular tachycardia lasting more than 30 seconds) as the outcome.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results: </strong>A total of 128 patients were included in this study, of whom 43 (33.6%) were female, with a median age of 74 years [66; 78]. The median follow-up duration was 34 months [16; 51]. Baseline characteristics were not significantly different between groups (Table 1). The median pro-BNP variation in the study population was -413 pg/mL [-1991; 277].</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif">The occurrence of ventricular arrhythmias was significantly higher in patients with a positive variation in pro-BNP levels compared to those with a negative variation (21.9% vs. 3.5%, p < 0.001).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"> Among patients who experienced ventricular arrhythmias, the median pro-BNP variation was 440 pg/mL [-118.3; 1054]. Survival analysis using Cox regression revealed that an increase in pro-BNP levels 1 year after CRT implantation was associated with a significantly higher risk of ventricular arrhythmias later in follow-up (HR: 5.409 [95% CI: 1.335–9.687], p = 0.017, Figure 1).</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong>In this population, an increase in pro-BNP levels in the first year after CRT implantation was associated with a higher occurrence of ventricular arrhythmias later in the follow-up. This suggests that pro-BNP could serve as a potential risk marker for ventricular arrhythmias, enabling earlier identification of patients at increased risk. However, further studies are necessary to validate these findings.</span></span></p>
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