International Journal of Cardiology 187 (2015) 234
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Morbidity and mortality in systolic heart failure also associated with raised serum neprilysin levels Oscar M.P. Jolobe ⁎ Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL, United Kingdom
a r t i c l e
i n f o
Article history: Received 19 February 2015 Accepted 17 March 2015 Available online 19 March 2015 Keywords: Serum Neprilysin Systolic Heart Failure Prognosis
composite end point which included cardiovascular death or heart failure (HF) hospitalisation (Hazard Ratio [HR] 1.18; 95% Confidence Interval [CI]: 1.07 to 1.31; p = 0.001), and cardiovascular death (HR: 1.18; 95% CI 1.05 to 1.32; p = 0.006) (2). Previously documented risk factors for morbidity and mortality such as low left ventricular ejection fraction, poor renal function, low systolic blood pressure, poor New York Heart Association functional class [1] showed no correlation with serum neprilysin levels [2]. Resting heart rate, however, was not included in the multivariate analysis. In conclusion, over and above the top ten risk factors recently documented [1], it would be worthwhile to implement the suggestion made that serum neprilysin should be included in multivariate models that evaluate prognosis in systolic heart failure [3]. Conflict of interest
Over and above the top ten risk factors for morbidity and mortality in patients with chronic systolic failure [1], it now appears that account will also have to be taken of elevated serum neprilysin levels when predicting cardiovascular death and heart failure hospitalisation in patients with systolic heart failure [2]. The predictive role of serum neprilysin was documented in a study which enrolled 1069 consecutive ambulatory patients of mean age 66.2 (71.8% males) receiving treatment for systolic heart failure in a multidisciplinary heart failure clinic between May 22, 2006 and May 22, 2013. The patients were followedup for a mean of 4.1 years. In comprehensive multivariate analyses, neprilysin concentrations were significantly associated with the
⁎ 1 Philip Godlee Lodge, 842 Wilmslow Road, Manchester M20 2DS, United Kingdom. E-mail address: [email protected].
http://dx.doi.org/10.1016/j.ijcard.2015.03.257 0167-5273/© 2015 Published by Elsevier Ireland Ltd.
I have no conflict of interest. References [1] I. Ford, M. Robertson, M. Komadja, M. Bohm, J. Borer, L. Tavazzi, et al., Top ten risk factors for morbidity and mortality in patients with chronic systolic heart failure and elevated heart rate: the SHIFT Risk Model, Int. J. Cardiol. 184 (2015) 163–169. [2] A. Bayes-Genis, J. Barallat, A. Galan, M. de Antonio, M. Domingo, E. Zamora, et al., Soluble neprilysin is predictive of cardiovascular death and heart failure hospitalization in heart failure patients, J. Am. Coll. Cardiol. 65 (2015) 657–665. [3] A. Jaffe, Unwinding the interaction of natriuretic peptides and neprilysin, J. Am. Coll. Cardiol. 65 (2015) 666–667.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Morbidity and mortality in systolic heart failure also associated with raised serum neprilysin levels Oscar M.P. Jolobe ⁎ Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL, United Kingdom
a r t i c l e
i n f o
Article history: Received 19 February 2015 Accepted 17 March 2015 Available online 19 March 2015 Keywords: Serum Neprilysin Systolic Heart Failure Prognosis
composite end point which included cardiovascular death or heart failure (HF) hospitalisation (Hazard Ratio [HR] 1.18; 95% Confidence Interval [CI]: 1.07 to 1.31; p = 0.001), and cardiovascular death (HR: 1.18; 95% CI 1.05 to 1.32; p = 0.006) (2). Previously documented risk factors for morbidity and mortality such as low left ventricular ejection fraction, poor renal function, low systolic blood pressure, poor New York Heart Association functional class [1] showed no correlation with serum neprilysin levels [2]. Resting heart rate, however, was not included in the multivariate analysis. In conclusion, over and above the top ten risk factors recently documented [1], it would be worthwhile to implement the suggestion made that serum neprilysin should be included in multivariate models that evaluate prognosis in systolic heart failure [3]. Conflict of interest
Over and above the top ten risk factors for morbidity and mortality in patients with chronic systolic failure [1], it now appears that account will also have to be taken of elevated serum neprilysin levels when predicting cardiovascular death and heart failure hospitalisation in patients with systolic heart failure [2]. The predictive role of serum neprilysin was documented in a study which enrolled 1069 consecutive ambulatory patients of mean age 66.2 (71.8% males) receiving treatment for systolic heart failure in a multidisciplinary heart failure clinic between May 22, 2006 and May 22, 2013. The patients were followedup for a mean of 4.1 years. In comprehensive multivariate analyses, neprilysin concentrations were significantly associated with the
⁎ 1 Philip Godlee Lodge, 842 Wilmslow Road, Manchester M20 2DS, United Kingdom. E-mail address: [email protected].
http://dx.doi.org/10.1016/j.ijcard.2015.03.257 0167-5273/© 2015 Published by Elsevier Ireland Ltd.
I have no conflict of interest. References [1] I. Ford, M. Robertson, M. Komadja, M. Bohm, J. Borer, L. Tavazzi, et al., Top ten risk factors for morbidity and mortality in patients with chronic systolic heart failure and elevated heart rate: the SHIFT Risk Model, Int. J. Cardiol. 184 (2015) 163–169. [2] A. Bayes-Genis, J. Barallat, A. Galan, M. de Antonio, M. Domingo, E. Zamora, et al., Soluble neprilysin is predictive of cardiovascular death and heart failure hospitalization in heart failure patients, J. Am. Coll. Cardiol. 65 (2015) 657–665. [3] A. Jaffe, Unwinding the interaction of natriuretic peptides and neprilysin, J. Am. Coll. Cardiol. 65 (2015) 666–667.
