Abstract 16741: Impact of Level of Post-procedural B-type Natriuretic Peptides on Mortality After Successful Transcatheter Edge-to-Edge Mitral Valve Repair Using MitraClip
Introduction: High level B-type natriuretic peptide (BNP) is associated with poor outcomes in patient with valvular heart disease. However, prognostic impact of post-procedural BNP level in patient undergoing MitraClip was not thoroughly evaluated.
Methods: A retrospective single center study was conducted in 147 consecutive patients who were successfully treated by MitraClip for severe mitral regurgitation. BNP level was measured in all patients at 30-day follow-up. The study population was grouped based on BNP level: low BNP (≤ 256 pg/mL), mid BNP (257-517 pg/mL), and high BNP (≥518 pg/mL) and post-procedural mortality was compared.
Results: Low BNP group was at lower baseline surgical risk compared with mid, and high BNP group (STS score 7.3±5.9 vs 11.6±7.6 vs 13.9±7.7, respectively, p<0.001). All-cause death at 1-year follow-up was 6.1%, 10.2%, and 26.5%, respectively (p=0.009). Mortality rate at 2-year follow-up was significantly higher in high BNP group (8.2% vs 24.5% vs 38.8% for the low, mid, and high BNP level, respectively; p=0.002). Stepwise Cox proportional hazards model demonstrated that high tertile of post-procedural BNP level was associated with all-cause death over 2-year follow-up after MitralClip procedure (hazard ratio 2.57 [95% CI 1.32-5.01], p=0.005).
Conclusions: High 30-day post-procedural BNP level was independently related to increase of mortality in patients who underwent successful MitraClip for severe mitral regurgitation.
Author Disclosures: K. Meemook: None. M. Nakamura: None. S. Kubo: None. Y. Nakajima: None. Y. Mizutani: None. G. Song: None. S. Kar: Research Grant; Significant; Abbott Vascular, Boston Scientific, Gore Medical. Honoraria; Significant; Abbott Vascular, Boston Scientific, Gore Medical.
- © 2016 by American Heart Association, Inc.