International Journal of Cardiology 187 (2015) 234

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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 composite end point which included cardiovascular death or heart

failure (HF) hospitalisation (Hazard Ratio [HR] 1.18; 95% Condence In-
Article history:
terval [CI]: 1.07 to 1.31; p = 0.001), and cardiovascular death (HR: 1.18;
Received 19 February 2015
Accepted 17 March 2015
95% CI 1.05 to 1.32; p = 0.006) (2). Previously documented risk factors
Available online 19 March 2015 for morbidity and mortality such as low left ventricular ejection fraction,
poor renal function, low systolic blood pressure, poor New York Heart
Keywords: Association functional class [1] showed no correlation with serum
Serum
neprilysin levels [2]. Resting heart rate, however, was not included in
Neprilysin
Systolic the multivariate analysis. In conclusion, over and above the top ten
Heart risk factors recently documented [1], it would be worthwhile to imple-
Failure ment the suggestion made that serum neprilysin should be included in
Prognosis multivariate models that evaluate prognosis in systolic heart failure [3].

Conict 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 treat-
ment for systolic heart failure in a multidisciplinary heart failure clinic
between May 22, 2006 and May 22, 2013. The patients were followed-
up for a mean of 4.1 years. In comprehensive multivariate analyses,
neprilysin concentrations were signicantly associated with the
I have no conict 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) 163169.
[2] A. Bayes-Genis, J. Barallat, A. Galan, M. de Antonio, M. Domingo, E. Zamora, et al., Sol-
uble neprilysin is predictive of cardiovascular death and heart failure hospitalization
in heart failure patients, J. Am. Coll. Cardiol. 65 (2015) 657665.
[3] A. Jaffe, Unwinding the interaction of natriuretic peptides and neprilysin, J. Am. Coll.
Cardiol. 65 (2015) 666667.

1 Philip Godlee Lodge, 842 Wilmslow Road, Manchester M20 2DS, United Kingdom.
E-mail address: oscarjolobe@yahoo.co.uk.

http://dx.doi.org/10.1016/j.ijcard.2015.03.257
0167-5273/ 2015 Published by Elsevier Ireland Ltd.