Researchers identified the threshold level of the biomarker neuropeptide Y (NPY) associated with adverse outcomes in patients with stable chronic heart failure undergoing cardiac resynchronization therapy (CRT) device implantation, according to study results published in JAMA Cardiology.

Blood samples from 105 patients who underwent cardiac resynchronization therapy device implantation were drawn, stored, and later analyzed for NPY levels. In general, significantly greater NPY levels were observed in women, patients with diabetes, and patients with hypertension. After a follow-up period of 28 months, patient outcomes were analyzed and major adverse cardiovascular events (MACE) — defined as cardiac transplant, death, or ventricular assist device placement — were noted.

By the follow-up period, MACE occurred in 20 (19%) of the 105 patients studied. Coronary sinus NPY concentration greater than 130 pg/mL was found to be an inflection point after which patients were more likely to experience adverse outcomes. The most common adverse outcome was death, which occurred in 18 cases. Transplantation and left ventricular assist device placement each occurred in 1 case.

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The researchers concluded that coronary sinus NPY levels are associated with risk of MACE and hospitalization for heart failure (an additional outcome). The study corroborates prior research showing elevated circulating NPY levels during acute coronary syndromes and higher concentrations of coronary sinus NPY in patients with heart failure.

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Limitations of the study include the fact that all patients underwent CRT implantation, which may have limited the scope of the findings. The researchers note that their findings warrant further research to examine the effect of NPY levels in patients with heart failure and their potential as a prognostic tool.


Ajijola OA, Chatterjee NA, Gonzales MJ, et al. Coronary sinus neuropeptide Y levels and adverse outcomes in patients with stable chronic heart failure. JAMA Cardiol. Published online December 26, 2019. doi:10.1001/jamacardio.2019.4717.8i0