title: Impact of Preprocedural B-Type Natriuretic Peptide Levels on the Outcomes After Transcatheter Aortic Valve Implantation.
abstract: There are limited data on the effect of baseline B-type natriuretic peptide (BNP) on the outcome after transcatheter aortic valve implantation (TAVI). We investigated the influence of baseline BNP levels on the short-term and midterm clinical outcomes after TAVI. During a 3-year period, 780 patients with severe aortic stenosis underwent TAVI at our institute and had baseline BNP levels. We compared the high, mid, and low tertiles of BNP levels. TAVI end points, device success, and adverse events were considered according to the Valve Academic Research Consortium 2 definitions. Device success was significantly lower for patients with high BNP (98.1% vs 96.2% vs 91.9% for the low, mid, and high BNP tertiles, respectively; p = 0.003). All-cause mortality up to 30 days was 1.2% (3 of 260) versus 2.3% (6 of 260) versus 5% (13 of 260), respectively (p = 0.03). Six-month mortality rate was 4.1% (10 of 241) for the low BNP tertile, 5% (12 of 239) for the mid BNP tertile, and 17.1% (40 of 234) for the high BNP tertile (p <0.001). In the multivariate model, high tertile of baseline BNP was found to be significantly associated with all-cause mortality (hazard ratio 3.3, 95% confidence interval 1.64 to 6.48; p = 0.001). In conclusion, elevated BNP levels are associated with increased short-term and midterm mortality after TAVI. We recommend measurement of baseline BNP as part of risk stratification models for TAVI.
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California. Electronic address: yigalab@yahoo.com.
authors.forename: Yigal
authors.initials: Y
authors.lastname: Abramowitz
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Tarun
authors.initials: T
authors.lastname: Chakravarty
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Hasan
authors.initials: H
authors.lastname: Jilaihawi
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Chin
authors.initials: C
authors.lastname: Lee
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Justin
authors.initials: J
authors.lastname: Cox
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Rahul P
authors.initials: RP
authors.lastname: Sharma
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Geeteshwar
authors.initials: G
authors.lastname: Mangat
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California.
authors.forename: Wen
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, California. Electronic address: Raj.Makkar@cshs.org.
authors.forename: Raj R
authors.initials: RR
authors.lastname: Makkar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D002140:California / Q000453:epidemiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D061330:Multidetector Computed Tomography; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D057234:Preoperative Period; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D020097:Natriuretic Peptide, Brain