The value of N-terminal pro-B-type natriuretic peptide (NT Pro-BNP) to predict sudden cardiac death in chronic heart failure patients with normal renal function; a systematic review and meta-analysis

Abstract

Context: The role of N-terminal pro-B-type natriuretic peptide (NT pro-BNP) has been understood as an important and critical biomarker in the diagnosis and predicting poor outcome of cardiac dysfunction. Objectives: We aimed to systematically review the papers on the value of NT pro-BNP in prediction of sudden cardiac death (SCD) in chronic heart failure (CHF) patients. Data Sources: This study was based on the Systematic Reviews and Meta-analysis (PRISMA) study reporting system. Study Selection: During the deep searches using the keywords, 67 studies were initially considered for primary assessment. Of those, 12 were completely matched with the study endpoint. In final, six were excluded because of unavailability of full texts or acquired data and thus six studies were finally analyzed. Data Extraction: Two researchers independently used the key words "chronic heart failure, B-type natriuretic peptide, sudden cardiac death" and their combination and searched the national and international databases including Scopus, PubMed, Science Direct, Web of Science, Springer, and the Google Scholar search engine. Results: The pooled prevalence of SCD in CHF patients was found to be 6.9% (95% CI: 5.2% to 9.0%). The statistical heterogeneity was high with an I2 of 84.488. Abnormal elevated level of NT pro-BNP was significantly associated with the increased risk for SCD with a hazard ratio of 4.2 (95% CI: 2.2 to 8.7). Conclusion: Measuring the serum level of NT pro-BNP in CHF patients can be valuable to predict long-term SCD. In this regard, significant elevation of this biomarker may be associated with the four-fold risk of SCD in such patients.

Current Trends in Biohumoral Screening for the Risk of Sudden Cardiac Death: A Systematic Review

“…The dosage of NT-pro BNP is considered useful in terms of additional contribution to the prediction of cardiovascular events, including among individuals without a history of cardiovascular disease, as demonstrated in a meta-analysis of 40 prospective studies in 12 countries [ 64 ]. Meta-analyses have shown the predictive role of NT-pro BNP in cardiovascular events among patients with chronic cardiovascular diseases, such as chronic heart failure [ 65 , 66 ]. At the same time, the meta-analysis conducted by Cao et al on necropsy studies exposes higher levels of NT-pro BNP in pericardial fluid in cases of sudden cardiac death compared to those of sudden non-cardiac death, suggesting postmortem NT-proBNP from pericardial fluid may be considered as an indicator in assessing agonal heart function [ 67 ].…”

Omega‐3 fatty acids and endothelial function: A GRADE‐assessed systematic review and meta‐analysis

“…At first, a systematic search was done in the following databases without any restriction in time and language: MEDLINE, SciVerse, Scopus and Clarivate Analytics Web of Science databases. We used the following keywords and Medical Subject Heading (MeSH) to recover potentially pertinent articles 1 : omega‐3 fatty acid (FA) 2 ; endothelial function 3 randomized controlled trial (Table S1). We also searched the reference lists of included trials and relevant reviews for further qualified studies that were ignored by our electronic search.…”

“…There is an increasing rate of cardiovascular diseases (CVDs) and associated mortality worldwide, which makes them the leading cause of death. 1,2 CVD initiation is affected by endothelial dysfunction, which is one of the premature steps in the pathological development of atherosclerotic diseases. 2 Endothelial dysfunction is associated with raised expression of inflammatory cytokines and adhesion molecules, factors that play a role in plaque formation and eventually plaque rupture.…”

“…There is an increasing rate of cardiovascular diseases (CVDs) and associated mortality worldwide, which makes them the leading cause of death 1,2 . CVD initiation is affected by endothelial dysfunction, which is one of the premature steps in the pathological development of atherosclerotic diseases 2 .…”