Key result
Higher secretoneurin linked to ~14% greater mortality risk per 10 pmol/L increase in reduced LVEF.
Why the study?
Secretoneurin is associated with mortality risk in heart failure and may influence cardiac arrhythmia risk, but its relationship with ventricular tachyarrhythmias and death in patients with LV systolic dysfunction is unclear.
Does baseline and serial measurement of circulating secretoneurin predict the risk of ventricular tachyarrhythmias and death in ambulatory patients with LVEF ≤ 35% and a primary-prevention ICD?
Cohort (n=154)
No
Does baseline and serial measurement of circulating secretoneurin predict the risk of ventricular tachyarrhythmias and death in ambulatory patients with LVEF ≤ 35% and a primary-prevention ICD?
Hazard Ratio: 1.14 (95% CI 1.02–1.27)
p-value: p=0.020
Secretoneurin concentration is associated with an increased risk of death, but not ventricular tachyarrhythmias, in stable ambulatory patients with reduced LV systolic function and a primary prevention ICD.
May refine mortality risk stratification in reduced-EF patients; leaves open any role in ventricular arrhythmia prediction or ICD decisions.
BACKGROUND: Secretoneurin, a member of the granin protein family, is associated with the risk of mortality in patients with acute and chronic heart failure. Secretoneurin may play an important role in cardiomyocyte calcium handling, suggesting that it may influence cardiac arrhythmia risk. We hypothesized that baseline and serial measurements of circulating secretoneurin are associated with the risk of incident ventricular tachyarrhythmias (VA) and death, and that serial measurement would provide prognostic information beyond baseline values. METHODS: We measured circulating secretoneurin concentrations in blood samples obtained at 3-month intervals for one year in a prospectively enrolled cohort of ambulatory patients with left ventricular ejection fraction (LVEF) ≤ 35 % and a primary-prevention implanted cardioverter defibrillator (ICD). Associations between secretoneurin modeled as a time-dependent variable and the incidences of VA and death were assessed. RESULTS: 154 patients (66 ± 14 years, LVEF 23 ± 8 %) were included in the analysis. During one-year follow-up, 26 (17 %) patients experienced VA, and 16 (10 %) died. Adjusting for age, sex, eGFR, and LVEF, baseline secretoneurin concentration was associated with the risk of death (hazard ratio (HR) per 10 pmol/L increase: 1.14 (95 % CI: 1.02-1.27), p = 0.020) but not VA (HR: 0.98 (0.81-1.19), p = 0.856). Using serial measurements at 3-month intervals, time-varying secretoneurin was associated with a similarly higher risk of death (HR: 1.14 (1.02-1.27), p = 0.017) but not of VA (HR: 0.97 (0.81-1.17), p = 0.776). CONCLUSION: In stable ambulatory patients with reduced LV systolic function and a primary prevention indication for ICD, secretoneurin concentration was associated with the risk of death but not ventricular tachyarrhythmia.
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Omland et al. (2024) conducted a cohort in Left ventricular systolic dysfunction (n=154). Secretoneurin concentration vs. Lower secretoneurin concentration was evaluated on Risk of death (per 10 pmol/L increase in baseline secretoneurin) (HR 1.14, 95% CI 1.02-1.27, p=0.020). Higher baseline secretoneurin concentration was associated with an increased risk of death (HR 1.14 per 10 pmol/L increase) but not ventricular tachyarrhythmia in patients with reduced left ventricular systolic function.
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