Abstract 10489: Truncated SCN5A mRNA Splicing Variants in Blood Predict Implantable Cardioverter-Defibrillator Events in Heart Failure
Objective: This study investigated whether truncated SCN5A mRNA splicing variants (VC and VD) in white blood cells (WBCs) predicted arrhythmic risk in heart failure (HF).
Methods: Four groups of subjects were recruited: controls, HF without an implantable cardioverter-defibrillator (ICD) (HF), HF with an ICD and no appropriate therapy (ICD(-)Event) and HF with an ICD and appropriate therapies (ICD(+)Event). WBC VC and VD levels and the occurrence of retrospective ICD events within the one year of blood sample acquisition were determined in the groups.
Results: HF patients who had received appropriate ICD therapies had significantly higher levels of VC and VD than the other two groups as shown in Figure 1. In addition, elevated VC and VD levels were associated with increased risk of an ICD event. The diagnostic odds ratio (DOR) of VC was 3.85 with 95% confidence interval (CI) being 2.00-7.43, while the DOR of VD was 3.04 with 95% CI being 1.83-5.05. The areas under the receiver operating characteristic curves for determination of appropriate ICD therapies using WBC SCN5A variants levels were ≥ 0.97, suggesting that truncated SCN5A variants in blood had a high predictive power for lethal arrhythmia.
Conclusions: Truncated SCN5A mRNA splicing variants in blood correlate with arrhythmic risk and could be used to predict ICD events in HF population. Therefore, truncated SCN5A splicing variant levels in blood may help identify patients with HF who might benefit most from device implantation.
- © 2013 by American Heart Association, Inc.