TY - JOUR
T1 - Risk stratification of ischaemic patients with implantable cardioverter defibrillators by C-reactive protein and a multi-markers strategy
T2 - Results of the CAMI-GUIDE study
AU - Biasucci, Luigi M.
AU - Bellocci, Fulvio
AU - Landolina, Maurizio
AU - Rordorf, Roberto
AU - Vado, Antonello
AU - Menardi, Endrj
AU - Giubilato, Giovanna
AU - Orazi, Serafino
AU - Sassara, Massimo
AU - Castro, Antonello
AU - Massa, Riccardo
AU - Kheir, Antoine
AU - Zaccone, Gabriele
AU - Klersy, Catherine
AU - Accardi, Francesco
AU - Crea, Filippo
PY - 2012/6
Y1 - 2012/6
N2 - AimsPatients at risk of sudden cardiac death (SCD) after myocardial infarction (MI) can be offered therapy with implantable cardioverter defibrillators (ICDs). Whether plasma biomarkers can help risk stratify for SCD and ventricular arrhythmias (VT/VF) is unclear. Methods and resultsThe primary objective of the CAMI-GUIDE study is to assess the predictive role of C-reactive protein for SCD or VT/VF in ischaemic patients with the ejection fraction 3 mg/L [heart rate (HR) 0.91 (0.50-1.64) P = 0.76], while C-reactive protein >3 mg/L was strongly associated with mortality due to heart failure [HR: 3.17 (1.54-6.54) P = 0.002]. NT-proBNP above median was significantly associated with the primary endpoint [adjusted HR: 1.46 (1.020-2.129) P = 0.042]. A risk function, including the three biomarkers, NYHA class and resting HR, allowed stratification of patient mortality risk from 5 to 50%. Conclusion C-reactive protein >3 mg/L is not associated with SCD or fast VT/VF, however, is a strong predictor of HF mortality. Biomarkers combined with clinical markers allow an excellent risk stratification of mortality at 2 years.
AB - AimsPatients at risk of sudden cardiac death (SCD) after myocardial infarction (MI) can be offered therapy with implantable cardioverter defibrillators (ICDs). Whether plasma biomarkers can help risk stratify for SCD and ventricular arrhythmias (VT/VF) is unclear. Methods and resultsThe primary objective of the CAMI-GUIDE study is to assess the predictive role of C-reactive protein for SCD or VT/VF in ischaemic patients with the ejection fraction 3 mg/L [heart rate (HR) 0.91 (0.50-1.64) P = 0.76], while C-reactive protein >3 mg/L was strongly associated with mortality due to heart failure [HR: 3.17 (1.54-6.54) P = 0.002]. NT-proBNP above median was significantly associated with the primary endpoint [adjusted HR: 1.46 (1.020-2.129) P = 0.042]. A risk function, including the three biomarkers, NYHA class and resting HR, allowed stratification of patient mortality risk from 5 to 50%. Conclusion C-reactive protein >3 mg/L is not associated with SCD or fast VT/VF, however, is a strong predictor of HF mortality. Biomarkers combined with clinical markers allow an excellent risk stratification of mortality at 2 years.
KW - Brain natriuretic peptide
KW - C-reactive protein
KW - Implantable cardioverter defibrillator
KW - Myocardial infarction
KW - Sudden cardiac death
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U2 - 10.1093/eurheartj/ehr487
DO - 10.1093/eurheartj/ehr487
M3 - Article
C2 - 22285581
AN - SCOPUS:84861830092
VL - 33
SP - 1344
EP - 1350
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 11
ER -