TY  - BOOK
AU  - Eldadah, Zayd A
TI  - Protein biomarkers identify patients unlikely to benefit from primary prevention implantable cardioverter defibrillators: findings from the Prospective Observational Study of Implantable Cardioverter Defibrillators (PROSE-ICD)
SN  - 1941-3084
KW  - *Blood Proteins/an [Analysis]
KW  - *Death, Sudden, Cardiac/pc [Prevention & Control]
KW  - *Defibrillators, Implantable
KW  - *Electric Countershock/is [Instrumentation]
KW  - *Primary Prevention/is [Instrumentation]
KW  - Aged
KW  - Biological Markers/bl [Blood]
KW  - Chi-Square Distribution
KW  - Death, Sudden, Cardiac/et [Etiology]
KW  - Female
KW  - Humans
KW  - Inflammation Mediators/bl [Blood]
KW  - Linear Models
KW  - Male
KW  - Middle Aged
KW  - Multivariate Analysis
KW  - Myocardium/me [Metabolism]
KW  - Natriuretic Peptide, Brain/bl [Blood]
KW  - Patient Selection
KW  - Predictive Value of Tests
KW  - Primary Prevention/mt [Methods]
KW  - Proportional Hazards Models
KW  - Prospective Studies
KW  - Protein Precursors/bl [Blood]
KW  - Risk Assessment
KW  - Risk Factors
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Multicenter Study
KW  - Observational Study
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 2008 - present
N2  - BACKGROUND: Primary prevention implantable cardioverter defibrillators (ICDs) reduce all-cause mortality, but the benefits are heterogeneous. Current risk stratification based on left ventricular ejection fraction has limited discrimination power. We hypothesize that biomarkers for inflammation, neurohumoral activation, and cardiac injury can predict appropriate shocks and all-cause mortality in patients with primary prevention ICDs; CLINICAL TRIAL REGISTRATION URL: clinicaltrials.gov; Unique Identifier: NCT00733590.Copyright � 2014 American Heart Association, Inc; CONCLUSIONS: An increase in serum biomarkers of inflammation, neurohumoral activation, and myocardial injury increased the risk for death but poorly predicted the likelihood of an ICD shock. These findings highlight the potential importance of serum-based biomarkers in identifying patients who are unlikely to benefit from primary prevention ICDs; METHODS AND RESULTS: The Prospective Observational Study of Implantable Cardioverter Defibrillators (PROSe-ICD) enrolled 1189 patients with systolic heart failure who underwent ICD implantation for primary prevention of sudden cardiac death. The primary end point was an ICD shock for adjudicated ventricular tachyarrhythmia. The secondary end point was all-cause mortality. After a median follow-up of 4.0 years, 137 subjects experienced an appropriate ICD shock and 343 participants died (incidence rates of 3.2 and 5.8 per 100 person-years, respectively). In multivariable-adjusted models, higher interleukin-6 levels increased the risk of appropriate ICD shocks. In contrast, C-reactive protein, interleukin-6, tumor necrosis factor-alpha receptor II, pro-brain natriuretic peptide (pro-BNP), and cardiac troponin T showed significant linear trends for increased risk of all-cause mortality across quartiles. A score combining these 5 biomarkers identified patients who were much more likely to die than to receive an appropriate shock from the ICD
UR  - http://dx.doi.org/10.1161/CIRCEP.113.001705
ER  -