Author + information
- Pavida Pachariyanon,
- Sorin Pislaru,
- Mackram Eleid,
- Gurpreet Sandhu,
- Kevin Greason,
- David Joyce and
- Vuyisile Nkomo
Background: Chronic lung disease (CLD) is independently associated with adverse outcomes after transcatheter aortic valve replacement (TAVR). The aim of the present study was to evaluate the prognostic value of baseline plasma N-terminal prohormone B-type natriuretic peptide (NT-proBNP) in CLD patients with severe aortic stenosis (AS) undergoing TAVR.
Methods: Clinical records for 219 CLD patients with severe AS undergoing TAVR from June 2009 to June 2014 at the Mayo Clinic were analyzed. NT-proBNP was measured before the procedure. Clinical outcomes over 2 years were recorded and were evaluated across tertiles of baseline NT-proBNP levels (tertile 1, ≥ 2,901 pg/ml; tertile 2, 1,001-2,900 pg/ml; tertile 3, ≤ 1,000 pg/ml).
Results: Mean age was 79.81 +/-8.17, and 62.56% were male. TAVR was transfemoral in 53% and transapical in 39 %. CLD patients with a high baseline NT-proBNP (tertile 1) compared with a low baseline NT-proBNP (tertiles 2 and 3) had a higher 1-year all-cause mortality rate (25.33% vs 13.33% and 10.14% respectively; p=0.03) and 2-year all-cause mortality rate (34.67% vs 22.67% and 14.49% respectively; p=0.02). On a multivariate analysis adjusting for gender, age, STS score and left ventricular ejection fraction (LVEF), CLD patients with a high baseline NT-proBNP (tertile 1) had an increased risk of 2-year all-cause mortality (adjusted odds ratio 2.62; 95% confidence interval 1.04-6.59; p=0.04).
Conclusions: High baseline NT-proBNP (tertile 1) independently predicts all-cause mortality during long-term follow up in CLD patients with severe AS undergoing TAVR. Level of pre-TAVR NT-proBNP elevation in patients with CLD may help inform patient prognosis following TAVR.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-193
- 2017 American College of Cardiology Foundation