PT - JOURNAL ARTICLE AU - Guixin Wu AU - Jie Liu AU - Shuiyun Wang AU - Shiqin Yu AU - Ce Zhang AU - Dong Wang AU - Mo Zhang AU - Yaoyao Yang AU - Lianming Kang AU - Shihua Zhao AU - Rutai Hui AU - Yubao Zou AU - Jizheng Wang AU - Lei Song TI - N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy AID - 10.1136/heartjnl-2020-317701 DP - 2021 Oct 01 TA - Heart PG - 1576--1583 VI - 107 IP - 19 4099 - http://heart.bmj.com/content/107/19/1576.short 4100 - http://heart.bmj.com/content/107/19/1576.full SO - Heart2021 Oct 01; 107 AB - Objective Elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with heart failure-related death in hypertrophic cardiomyopathy (HCM), but the relationship between NT-proBNP level and sudden cardiac death (SCD) in HCM remains undefined.Methods The study prospectively enrolled 977 unrelated patients with HCM with available NT-proBNP results who were prospectively enrolled and followed for 3.0±2.1 years. The Harrell’s C-statistic under the receiver operating characteristic curve was calculated to evaluate discrimination performance. A combination model was constructed by adding NT-proBNP tertiles to the HCM Risk-SCD model. The correlation between log NT-proBNP level and cardiac fibrosis as measured by late gadolinium enhancement (LGE) or Masson’s staining was analysed.Results During follow-up, 29 patients had SCD. Increased log NT-proBNP levels were associated with an increased risk of SCD events (adjusted HR 22.27, 95% CI 10.93 to 65.63, p<0.001). The C-statistic of NT-proBNP in predicting SCD events was 0.80 (p<0.001). The combined model significantly improved the predictive efficiency of the HCM Risk-SCD model from 0.72 to 0.81 (p<0.05), with a relative integrated discrimination improvement of 0.002 (p<0.001) and net reclassification improvement of 0.67 (p<0.001). Furthermore, log NT-proBNP levels were significantly correlated with cardiac fibrosis as detected either by LGE (r=0.257, p<0.001) or by Masson’s trichrome staining in the myocardium (r=0.198, p<0.05).Conclusion NT-proBNP is an independent predictor of SCD in patients with HCM and may help with risk stratification of this disease.Data are available upon reasonable request.