The Predictive Value and Evolution of N-Terminal Pro-B-Type Natriuretic Peptide Levels Following Transcutaneous Aortic Valve Implantation

Aims: We sought to define the predictive value and evolution of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels following transcutaneous aortic valve implantation (TAVI). Methods and Results: We investigated 91 consecutive patients who underwent TAVI (59 transfemoral [TF], 32 transapical [TA]) in our institution. The balloon‐expandable valve was implanted in 75 and the self‐expanding in 16 patients. The baseline (within 48 hours prior to procedure), early (24–74 hours), and late (3–12 months) postprocedural NT‐proBNP levels were determined. The mortality status of all patients was ascertained as of September 2010. The 30‐day and 1.3(mean)‐year mortality was 3% and 12% (2%, 9% in the TF and 6%, 19% in the TA group). Increased baseline (χ2= 5.9, P = 0.016) and early (χ2= 4.9, P = 0.028) NT‐proBNP levels were predictive of mortality. All decrements of the NT‐proBNP levels in the TF patients were significant (baseline 4,984 ± 8,106 vs. early 3,912 ± 6,551 pg/mL, P = 0.016; late 633 ± 606 pg/mL, P = 0.003). In contrast, there was a trend for the early levels to increase in the TA patients (6,423 ± 8,897 vs. 8,100 ± 10,178 pg/mL, P = 0.090), and a significant decline in the late levels as compared to baseline (1,704 ± 3,417 pg/mL, P = 0.005). Conclusion: NT‐proBNP levels are predictive of mortality following TAVI. There is a differential early evolution of their levels between the TF and TA patients and a significant decline later in both groups. (J Interven Cardiol 2011;24:462–469)