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Natriuretic peptides and long-term mortality in patients with severe aortic stenosis.
MedLine Citation:
PMID:  22808834     Owner:  NLM     Status:  In-Process    
BACKGROUND AND AIM OF THE STUDY: The natriuretic peptides, brain natriuretic peptide (BNP) and its N-terminal prohormone (NT-proBNP), can be used as diagnostic and prognostic markers for aortic stenosis (AS). However, the association between BNP, NT-proBNP, and long-term clinical outcomes in patients with severe AS remains uncertain.
METHODS: A total of 64 patients with severe AS was prospectively enrolled into the study, and underwent clinical and echocardiographic assessments at baseline. Blood samples were drawn for plasma BNP and NT-proBNP analyses. The primary outcome was death from any cause, through a six-year follow up period. Cox proportional hazards modeling was used to examine the association between natriuretic peptides and long-term mortality, adjusting for important clinical factors.
RESULTS: During a mean period of 1,520 +/- 681 days, 51 patients (80%) were submitted to aortic valve replacement, and 13 patients (20%) were medically managed without surgical interventions. Mortality rates were 13.7% in the surgical group and 62% in the medically managed group (p < 0.001). Patients with higher plasma BNP (> 135 pg/ml) and NT-proBNP (> 1,150 pg/ml) levels at baseline had a greater risk of long-term mortality (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.1-9.1; HR 4.3, 95% CI 1.4-13.5, respectively). After adjusting for important covariates, both BNP and NT-proBNP remained independently associated with long-term mortality (HR 2.9, 95% CI 1.5-5.7; HR 1.8, 95% CI 1.1-3.1, respectively).
CONCLUSION: In patients with severe AS, plasma BNP and NT-proBNP levels were associated with long-term mortality. The use of these biomarkers to guide treatment might represent an interesting approach that deserves further evaluation.
Marcelo Katz; Flavio Tarasoutchi; Antonio Eduardo Pereira Pesaro; Renato D Lopes; Guilherme Sobreira Spina; Marcelo Luiz Campos Vieira; Max Grinberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  21     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-07-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Heart Institute, University of Sao Paulo Medical School, Brazil.
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