Neuropeptide Y as a Prognostic Biomarker in Electrical Storm.

Abstract

Background: Electrical storm (ES), characterized by recurrent ventricular arrhythmias, presents a major clinical challenge, so the identification of dependable biomarkers of mortality is essential for risk stratification and targeted intervention.

Objectives: The aim of this study was to investigate the potential utility of neuropeptide Y (NPY) levels in association with mortality in patients experiencing drug-refractory ES.

Methods: A prospective cohort study was conducted, enrolling 95 patients diagnosed with ES. They were divided into 2 groups: a control group (n = 62) and a refractory group (n = 33). Demographic and clinical data were collected at enrollment. Plasma NPY levels were measured in hospitalization. A receiver-operating characteristic curve was used to define an NPY threshold, with Youden's index applied to identify the optimal cutoff point for heightened mortality risk in patients with ES. According to NPY threshold, patients were divided into a low NPY group and a high NPY group. The log-rank test was used for Kaplan-Meier survival curve comparison between 2 groups. Cox proportional hazards modeling was used to assess the association between NPY level and mortality.

Results: Patients in the refractory group exhibited significantly higher venous NPY levels compared with those in the control group. Receiver-operating characteristic analysis identified an NPY threshold of 44.4 pg/mL with sensitivity of 0.91 and specificity of 0.90. Elevated baseline NPY levels were significantly associated with an increased risk for mortality in patients with ES (95% CI: 0.89-0.99). The survival curves depicted a clear divergence between patients with high and low NPY levels, highlighting the association of elevated NPY level with increased mortality.

Conclusions: NPY emerges as a potential biomarker for risk stratification in patients experiencing ES.