Prognostic value of NT-proBNP and an adapted monin score in patients with asymptomatic aortic stenosis

Núria Farré, Miquel Gómez, Luis Molina, Mercedes Cladellas, Mireia Blé, Cristina Roqueta, Maria Soledad Ascoeta, Josep Comin-Colet, Joan Vila, Jordi Bruguera

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Abstract

Introduction and objectives Our objective was to assess the prognostic value of NT-proBNP in patients with asymptomatic moderate/severe aortic stenosis and to validate an adapted Monin score using natriuretic peptide levels in our setting. Methods Prospective study of 237 patients with degenerative asymptomatic moderate/severe aortic stenosis. NT-proBNP was determined in all patients, who were then followed up clinically. The adapted Monin score was defined as follows: (peak velocity [m/s]×2)+(logn NT-proBNP×1.5)(+1. 5 if woman). A clinical event was defined as surgery, hospital admission due to angina, heart failure or syncope, or death. Results A total of 51% were women, and the mean age was 74 years. Mean (SD) echocardiographic values were as follows: peak velocity 4.14 (0.87) m/s; mean gradient, 43.2 (16.0) mmHg; aortic valve area, 0.87 (0.72) cm2, and aortic valve area index, 0.49 (0.14) cm2/m2. The median NT-pro-BNP value was 490.0 [198.0-1312.0] pg/mL. There were 153 events during follow-up (median 18 months). The optimum NT-proBNP cut-point was 515 pg/mL, giving event-free survival rates at 1 and 2 years of 93% and 57%, respectively, in patients with NT-proBNP <515 pg/mL compared with 50% and 31% in those with NT-proBNP >515 pg/mL. Patients were divided into quartiles based on the Monin score. Event-free survival at 1 and 2 years was 87% and 79% in the first quartile, compared with 45% and 28% in the fourth quartile, respectively. Conclusions NT-proBNP determination provides prognostic information in patients with asymptomatic moderate/severe aortic stenosis. The adapted Monin score is useful in our setting and allows a more precise prognosis than does the use of NT-proBNP alone. © 2013 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved.
Original languageEnglish
Pages (from-to)52-57
JournalRevista Espanola de Cardiologia
Volume67
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Aortic valve stenosis
  • Echocardiography
  • Natriuretic peptides

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    Farré, N., Gómez, M., Molina, L., Cladellas, M., Blé, M., Roqueta, C., Ascoeta, M. S., Comin-Colet, J., Vila, J., & Bruguera, J. (2014). Prognostic value of NT-proBNP and an adapted monin score in patients with asymptomatic aortic stenosis. Revista Espanola de Cardiologia, 67(1), 52-57. https://doi.org/10.1016/j.recesp.2013.06.023