eISSN: 2345-4202  
J Nephropharmacol. 2018;7(2):164-168.

Review

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 

Mehrdad Sheikhvatan 1, Zhaleh Ataei 2 * , Aigin Heydari 2, Aryan Zahergivar 2

1 Neurology Department, Heidelberg University, Heidelberg, Germany
2 Department of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
*Corresponding author: Zhaleh Ataei, Email: Email: Zhale71@gmail.com

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.

Implication for health policy/practice/research/medical education:

Measuring the serum level of N-terminal pro-B-type natriuretic peptide (NT Pro-BNP) in chronic heart failure (CHF) patients can be valuable to predict long-term sudden cardiac death (SCD). In this regard, significant elevation of this biomarker may be associated with the four-fold risk of SCD in such patients. A few documents are available in the best cutoff value of this marker to achieve this goal with high sensitivity and specificity and thus more cross-sectional and cohort studies should be performed with the aim of yielding the best cutoff points of the marker.

Please cite this paper as: Sheikhvatan M, Ataei Z, Heydari A, Zahergivar A. 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. J Nephropharmacol. 2018;7(2):164-168. 

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Submitted: 10 May 2018

Accepted: 18 Jun 2018
First published online: 27 Jul 2018
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