Valvular & structural heart diseaseSecondary analysis
Low and elevated B-type natriuretic peptide levels are associated with increased mortality in patients with preserved ejection fraction undergoing transcatheter aortic valve replacement: an analysis of the PARTNER II trial and registry
- Secondary analysis of the PARTNER II randomised trial and registry
Authors' conclusion
In a large cohort of patients with severe symptomatic AS and preserved LVEF undergoing TAVR, all-cause and cardiovascular mortality rates at 2 years were higher in patients with low and markedly elevated BNP levels.
Study context
- Population
- Patients with symptomatic severe aortic stenosis (AS) and left ventricular ejection fraction (LVEF) ≥50% undergoing transcatheter aortic valve replacement (TAVR)
- Participants
- 1,782 patients
- Comparison
- Baseline BNP categories: low, moderately elevated and markedly elevated vs normal
- Lown = 86
- Normaln = 202reference
- Moderately elevatedn = 885
- Markedly elevatedn = 609
- Primary endpoint
- All-cause mortality
- Follow-up
- 2 years
Primary result
As reported in the abstract
Each group vs normalAdjusted hazard ratio (95% CI)P value
Low
2.6(1.3–5.0)
P-value 0.005Moderately elevated
1.6(1.0–2.6)
P-value 0.06Markedly elevated
2.1(1.3–3.5)
P-value 0.003Further findings
Log-transformed BNP vs all-cause and CV mortality
- Non-linear association after adjustment: both lowest and highest values associated with increased mortality
Original publication
Low and elevated B-type natriuretic peptide levels are associated with increased mortality in patients with preserved ejection fraction undergoing transcatheter aortic valve replacement: an analysis of the PARTNER II trial and registry. Eur Heart J. Published 28 December 2019. doi:10.1093/eurheartj/ehz892
Summarised from the published abstract; every number is checked against it