Natriuretic peptide levels in patients with aortic stenosis can help predict symptom onset, provide risk stratification, and aid aortic valve replacement decisions. However, not much is known about the prognostic significance and clinical outcomes of natriuretic peptide level measurement after TAVR.
This cohort study included a total of 3,391 patients (mean age 82 years) with severe symptomatic aortic stenosis who were at an intermediate, high, or prohibitive risk surgical risk of aortic valve replacement. The participants underwent TAVR. The B-type natriuretic peptide (BNP) levels after TAVR were measured. The primary outcomes of the study were all-cause mortality, rehospitalization, cardiovascular death.
At each follow-up time point, most patients had a BNP ratio greater than 1 (86.6% at baseline, 88.5% at discharge, 80.5% at 30 days, and 75.2% at 1 year). Multivariate adjustment suggested that every 1-point increase in BNP ratio at 30 days resulted in an increased hazard of all-cause death (HR 1.11), cardiovascular death (1.16), and rehospitalization (1.08). In patients with a BNP ratio of 2 or more, every 1-point increase in BNP ratio was associated with a reduced risk of all-cause death.
The research concluded that higher BNP levels after TAVR were associated with a higher risk of mortality and rehospitalizations.