P4665High sensitivity troponin t and n-terminal pro brain natriuretic peptide plasma levels predict long-term postoperative survival in patients with severe aortic stenosis admitted for valve implantation

Autor:	Michael Grimm, Thomas Senoner, Johannes Holfeld, David Zweiker, T Theurl, Gudrun Feuchtner, Severin Semsroth, Albrecht Schmidt, Uta C. Hoppe, Clemens Steinwender, Silvana Mueller, Fabian Barbieri, Thomas Lambert, Peter P. Rainer, Wolfgang Dichtl
Rok vydání:	2019
Předmět:	medicine.medical_specialty Troponin T business.industry Plasma levels Postoperative survival medicine.disease Stenosis Internal medicine Aortic valve stenosis medicine Cardiology In patient Cardiology and Cardiovascular Medicine business N-terminal pro-Brain Natriuretic Peptide
Zdroj:	European Heart Journal. 40
ISSN:	1522-9645 0195-668X
Popis:	Aims Optimal timing of valve implantation in patients with severe aortic stenosis (AS) is under debate, considering the subjective nature of symptom onset. We aimed to investigate the pre-procedural value of routinely available cardiac biomarkers in predicting postoperative long-term outcome in a large cohort undergoing either surgical or transcatheter aortic valve implantation. Methods The Tyrolean Aortic Stenosis Study-2 (TASS-2) group, a consortium of four university hospital centers in Austria, analysed pre-procedural high-sensitivity troponin T (hsTnT) and N-terminal pro brain natriuretic peptide (NT-proBNP) plasma levels in 3595 patients admitted for valve implantation because of severe aortic stenosis since 2007. Results Transcatheter aortic valve implantation was performed in 1517 (42.2%) of patients. During a median follow-up of 2.93 (1.91–4.92) years, 919 patients (25.6%) died, among them 556 (15.5%) due to cardiovascular causes. In multivariate cox regression analysis - adjusting for STS risk score (intermediate risk 4–8%, high risk >8%), degree of left ventricular systolic dysfunction (ejection fraction 30–50% and 50 ng/l); HR 1.38, CI 1.06–1.81, P=0.018 for mildly to moderately elevated NT-proBNP (defined by an increase of up to threefold of age- and sex-corrected normal range); HR 1.68, CI 1.29–2.18, P50 ng/l); HR 1.47, CI 1.13–1.91, P=0.004 for mildly to moderately elevated NT-proBNP; HR 1.96, CI 1.54–2.51, P Conclusion hsTNT and NT-proBNP strongly predict long-term postoperative survival in patients with severe AS admitted for valve implantation. Acknowledgement/Funding This work was supported by the Tiroler Wissenschaftsförderung: grant number TWF-2017-1-5, GZ: UNI-0404-2104
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::74043cbba6376acdc5b7b4dd0fe719d7 https://doi.org/10.1093/eurheartj/ehz745.1047 Zobrazit plný text záznamu