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158 NT-pro BNP and Survival in Aortic Stenosis
  1. Tamir Malley1,
  2. Vassilis Vassiliou1,
  3. Dominique Auger1,
  4. Claire Raphael1,
  5. Helen Berry2,
  6. Eva Nyktari1,
  7. Francisco Alpendurada1,
  8. Jackie Donovan2,
  9. Dudley Pennell1,
  10. Sanjay Prasad1
  1. 1Royal Brompton Hospital
  2. 2Department of Clinical Biochemistry

Abstract

Introduction Elevated NT-pro BNP is associated with worse outcome in patients with cardiomyopathy.

Hypothesis We hypothesized that a mild elevation in NT-pro BNP may be associated with a worse outcome in patients with Aortic Stenosis (AS).

Methods Between 2011 and 2015, consecutive consenting patients with moderate (1.0–1.5 cm2) or severe (<1 cm2) AS considered for aortic valve intervention (either for severe AS or moderate AS with coronary disease) who had a cardiovascular magnetic resonance (CMR) scan undertaken for anatomy and function and also had blood stored for biomarker analysis were included. NT-pro BNP was measured using one-step immunoassay sandwich method with a final fluorescent detection (ELFA). Survival was obtained from hospital notes, electronic records and the National Strategic Office.

Results 112 patients (76 ± 10 years, 78 male) were included. The group was dichotomised according to NT-pro BNP value, into normal NT-pro BNP value group (values from 0–300 pg/ml, 23 patients) and high group (>300 pg/ml, 89 patients). End point was all cause mortality. At a median of 12 months follow-up, 21 patients had died, all from the high NT-pro BNP group. The high NT-pro BNP group had significantly worse prognosis hazard ratio=3.6 (95% CI=1.24–10.44, p = 0.00184). Although the NT-pro BNP correlated with LVEF its association with outcome was independent of this.

Conclusions In a prospective mixed cohort of patients with AS undergoing investigations for consideration of aortic valve intervention, even a mild elevation in NT-pro BNP is associated with worse short term outcome. This can be taken into consideration regarding timing of intervention especially in the asymptomatic population.

Abstract 158 Figure 1

Survival in low and high NT - Pro BNP groups

  • Aortic Stenosis
  • BNP
  • Systolic Function

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