What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Risk of sudden cardiac death and ventricular arrhythmias (n=4590). Intervention: Raised Brain Natriuretic Peptide (BNP) vs. Lower/normal BNP. Primary outcome: Sudden cardiac death (SCD) (RR 3.68, 95% CI 1.90-7.14).

What does this research mean for the field?

Elevated levels of Brain Natriuretic Peptide (BNP) significantly predict the risk of sudden cardiac death and the occurrence of ventricular arrhythmias. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 29, 2009

Brain Natriuretic Peptide for the Prediction of Sudden Cardiac Death and Ventricular Arrhythmias: A Meta-Analysis

Key Result

A raised brain natriuretic peptide (BNP) level predicted sudden cardiac death (RR 3.68; 95% CI 1.90-7.14) and ventricular arrhythmias (RR 2.54; 95% CI 1.87-3.44).

Study Design

Type

Meta-Analysis (n=4,590)

Structured PICO

Does a raised BNP level predict sudden cardiac death and ventricular arrhythmias in patients with and without ICDs?

Population

14 studies pooling 4,590 patients, including 6 studies (n=3,543) of patients without implantable cardioverter defibrillators (ICDs) across a wide range of populations, and 8 studies (n=1,047) of patients with ICDs.

Intervention

Raised Brain Natriuretic Peptide (BNP) level

Comparator

Lower or normal BNP level

Outcome

Sudden cardiac death (SCD) and ventricular arrhythmias (VA)hard clinical

Elevated BNP is a significant predictor of sudden cardiac death and ventricular arrhythmias, though its incremental value over other risk stratification tools requires further prospective study.

Main Result

Effect estimate: RR 3.68 (95% CI 1.90-7.14)

Limitations

The benefit of BNP testing in addition to other risk stratification tests is unclear and needs prospective evaluation in combination with other tools.

Abstract

AIMS: The risk stratification of patients for sudden cardiac death (SCD) remains a challenge. Brain natriuretic peptide (BNP) predicts overall mortality in heart disease but it is unclear how well it predicts SCD. We therefore performed a meta-analysis of studies evaluating the accuracy of BNP to predict SCD and ventricular arrhythmias (VA). METHODS AND RESULTS: Electronic databases and published bibliographies were systematically searched (1984-2008). We found 14 studies that met our inclusion criteria. Six studies (3543 patients) evaluated BNP to predict SCD in patients without implantable cardioverter defibrillators (ICDs) across a wide range of populations. A raised BNP predicted SCD with a relative risk of 3.68 95% confidence interval (CI) 1.90, 7.14. Eight studies (1047 patients) evaluated BNP to predict the occurrence of VA in patients with ICDs. A raised BNP predicted the occurrence of VA with a relative risk of 2.54 (95% CI 1.87, 3.44). CONCLUSION: The measurement of BNP has significant value in predicting SCD and VA. However, the benefit of BNP testing in addition to other risk stratification tests is unclear and BNP needs to be evaluated prospectively in combination with other complementary risk stratification tools.

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Cite This Study

Scott et al. (Tue,) conducted a meta-analysis in Risk of sudden cardiac death and ventricular arrhythmias (n=4,590). Raised Brain Natriuretic Peptide (BNP) vs. Lower/normal BNP was evaluated on Sudden cardiac death (SCD) (RR 3.68, 95% CI 1.90-7.14). A raised brain natriuretic peptide (BNP) level predicted sudden cardiac death (RR 3.68; 95% CI 1.90-7.14) and ventricular arrhythmias (RR 2.54; 95% CI 1.87-3.44).

synapsesocial.com/papers/6a092ea3266340834eb630c0 https://doi.org/https://doi.org/10.1093/eurjhf/hfp123

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