Abstract 18100: Usfulness of B-Type Natriuretic Peptide Plasma Levels to Predict Long-Term Mortality After Transcatheter Aortic Valve Implantation
Introduction and hypothesis: B-type Natriuretic Peptide (BNP) has been shown to be useful for predicting long-term mortality after conventional aortic valve replacement. We assessed the hypothesis that the BNP levels also predicts long-term mortality after transcatheter aortic valve implantation (TAVI).
Methods: A total of 74 patients who underwent TAVI were included. Indications for TAVI were nonoperable or surgical high-risk patients (Logistic EuroSCORE > 20%). The mean age was 82.3 years and (46) 62% were female. The usual baseline clinical characteristics were registered, and pro-BNP was measured 24 hours before the procedure. The Cox proportional hazards model were used to evaluate these clinical factors and the BNP variable was converted into its logarithm for the multifactorial Cox analysis (Log-proBNP).
Results: The baseline clinical characteristics were similar among the survivors and nonsurvivors. BNP values were significantly lower in survivors [median (p25, p75)], [2245 pg/mL (1361 pg/mL, 4030 pg/mL)] than in nonsurvivors [6269 pg/mL (2937 pg/mL, 11028 pg/mL)], (p < 0.001). The multivariate analysis revealed that increased Log-proBNP levels were associated with a higher mortality rate [HR = 6.0 (IC 95%: 1.5-25), p = 0.012] after adjusting for gender, age, body mass index, glomerular filtration rate (calculated using the MDRD-4 formula) and left ventricular ejection fraction. Pairwise comparison of the ROC curves (Figure 1) showed a significantly better performance of Log-proBNP combined to the EuroSCORE compared with EuroSCORE alone for predicting mortality (area under the ROC EoroSCORE curve = 0.9295 and area under the ROC Log-proBNP + EuroSCORE curve = 0.9444).
Conclusions: Preprocedure plasma proBNP level is an independent predictor of long-term mortality in patients with aortic stenosis after TAVI. Besides, this value combined with the EuroSCORE value is stronger than EuroSCORE alone in risk stratification of these patients.
- © 2011 by American Heart Association, Inc.