Neuropeptide Y levels predict mortality risk in patients with drug-refractory ventricular electrical storm | Research

The takeaway

In 95 patients with electrical storm, those with refractory ventricular arrhythmias had significantly higher plasma NPY, with NPY >44.4 pg/mL (sensitivity 0.91, specificity 0.90) independently predicting mortality risk.

91% sensitivity for mortality prediction
NPY >44.4 pg/mL identified patients at high mortality risk from electrical storm with exceptional accuracy—a simple blood test for a life-threatening condition

What the researchers found

Refractory ES: significantly higher NPY vs controls. NPY threshold: 44.4 pg/mL (sensitivity 0.91, specificity 0.90). High NPY: significantly worse survival (Kaplan-Meier). Cox: NPY independently associated with mortality (95% CI 0.89-0.99). 95 patients (62 control, 33 refractory).

Why it matters

Electrical storm is a cardiac emergency with high mortality. Having a blood test (NPY >44.4 pg/mL) that identifies high-risk patients with 91% sensitivity could enable earlier aggressive intervention.

How the study worked

Prospective cohort. 95 ES patients (62 drug-responsive, 33 refractory). Plasma NPY by ELISA. ROC analysis. Kaplan-Meier survival. Cox proportional hazards.

What this study cannot tell us

Small study (95 patients). Single center. NPY as a single measurement. Prospective but not validated externally. Cannot determine if NPY causes or reflects worse outcomes.

How to read the evidence

Prospective cohort with ROC and survival analysis. Good biomarker discovery data needing external validation.

When this study was published

Published in 2025.

The bigger picture

NPY, released by the sympathetic nervous system during cardiac stress, emerges as both a mechanistic mediator and prognostic marker in life-threatening arrhythmias. This connects neuropeptide biology with cardiac electrophysiology.

Questions still open

Could NPY-lowering therapies improve ES outcomes?
Should NPY be measured routinely in ES patients?
Does NPY promote arrhythmias through direct cardiac effects?

Common questions

What is electrical storm and why is NPY relevant?

Electrical storm is a cardiac emergency where the heart has repeated dangerous rhythm disturbances. NPY is a neuropeptide released by the sympathetic nervous system during intense cardiac stress. This study found NPY levels above 44.4 pg/mL predicted which patients were at highest risk of dying, with 91% accuracy.

Could measuring NPY save lives in electrical storm?

Potentially. A simple blood test identifying high-risk patients (91% sensitivity) could guide decisions about more aggressive treatment—such as catheter ablation or mechanical circulatory support—before it is too late. Currently, such decisions are often made based on clinical judgment alone.

Read the original research

Neuropeptide Y as a Prognostic Biomarker in Electrical Storm.

JACC. Clinical electrophysiology, 11(4), 655-663

View on PubMed ↗Publisher’s paper ↗

Citation

Tang, Jianjun; Liu, Chengfeng; Wang, Zhuo; Zhu, Tongjian; Zhong, Min; Li, Yasai; Chen, Mingxian. (2025). Neuropeptide Y as a Prognostic Biomarker in Electrical Storm.. JACC. Clinical electrophysiology, 11(4), 655-663. https://doi.org/10.1016/j.jacep.2024.11.021