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Natriuretic peptides and long-term mortality in patients with severe aortic stenosis.

Publication ,  Journal Article
Katz, M; Tarasoutchi, F; Pesaro, AEP; Lopes, RD; Spina, GS; Vieira, MLC; Grinberg, M
Published in: J Heart Valve Dis
May 2012

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.

Duke Scholars

Published In

J Heart Valve Dis

ISSN

0966-8519

Publication Date

May 2012

Volume

21

Issue

3

Start / End Page

331 / 336

Location

England

Related Subject Headings

  • Survivors
  • Survival Rate
  • Severity of Illness Index
  • Respiratory System
  • Prognosis
  • Peptide Fragments
  • Outcome and Process Assessment, Health Care
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male
 

Citation

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Katz, M., Tarasoutchi, F., Pesaro, A. E. P., Lopes, R. D., Spina, G. S., Vieira, M. L. C., & Grinberg, M. (2012). Natriuretic peptides and long-term mortality in patients with severe aortic stenosis. J Heart Valve Dis, 21(3), 331–336.
Katz, Marcelo, Flavio Tarasoutchi, Antonio Eduardo Pereira Pesaro, Renato D. Lopes, Guilherme Sobreira Spina, Marcelo Luiz Campos Vieira, and Max Grinberg. “Natriuretic peptides and long-term mortality in patients with severe aortic stenosis.J Heart Valve Dis 21, no. 3 (May 2012): 331–36.
Katz M, Tarasoutchi F, Pesaro AEP, Lopes RD, Spina GS, Vieira MLC, et al. Natriuretic peptides and long-term mortality in patients with severe aortic stenosis. J Heart Valve Dis. 2012 May;21(3):331–6.
Katz, Marcelo, et al. “Natriuretic peptides and long-term mortality in patients with severe aortic stenosis.J Heart Valve Dis, vol. 21, no. 3, May 2012, pp. 331–36.
Katz M, Tarasoutchi F, Pesaro AEP, Lopes RD, Spina GS, Vieira MLC, Grinberg M. Natriuretic peptides and long-term mortality in patients with severe aortic stenosis. J Heart Valve Dis. 2012 May;21(3):331–336.

Published In

J Heart Valve Dis

ISSN

0966-8519

Publication Date

May 2012

Volume

21

Issue

3

Start / End Page

331 / 336

Location

England

Related Subject Headings

  • Survivors
  • Survival Rate
  • Severity of Illness Index
  • Respiratory System
  • Prognosis
  • Peptide Fragments
  • Outcome and Process Assessment, Health Care
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male