Risk stratification of ischaemic patients with implantable cardioverter defibrillators by C-reactive protein and a multi-markers strategy: Results of the CAMI-GUIDE study

Luigi M. Biasucci, Fulvio Bellocci, Maurizio Landolina, Roberto Rordorf, Antonello Vado, Endrj Menardi, Giovanna Giubilato, Serafino Orazi, Massimo Sassara, Antonello Castro, Riccardo Massa, Antoine Kheir, Gabriele Zaccone, Catherine Klersy, Francesco Accardi, Filippo Crea

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1344-1350
Number of pages7
JournalEuropean Heart Journal
Volume33
Issue number11
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Brain natriuretic peptide
  • C-reactive protein
  • Implantable cardioverter defibrillator
  • Myocardial infarction
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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