Comparison of Brain Natriuretic Peptide Plasma Levels Versus Logistic EuroSCORE in Predicting In-Hospital and Late Postoperative Mortality in Patients Undergoing Aortic Valve Replacement for Symptomatic Aortic Stenosis

Giovanni Battista Pedrazzini, Serge Masson, Roberto Latini, Catherine Klersy, Maria Grazia Rossi, Elena Pasotti, Francesco Fulvio Faletra, Francesco Siclari, Fabrizio Minervini, Tiziano Moccetti, Angelo Auricchio

Research output: Contribution to journalArticlepeer-review

Abstract

The accuracy of the logistic EuroSCORE (logES), a widely used risk prediction algorithm for cardiac surgery including aortic valve surgery, usually overestimates observed perioperative mortality. Elevated brain natriuretic peptide (BNP) in symptomatic patients with aortic stenosis (AS) is associated with a poor short-term outcome after aortic valve replacement. We aimed to compare BNP with the logES for predicting short- and long-term outcome in symptomatic patients with severe AS undergoing aortic valve replacement. We prospectively studied 144 consecutive patients referred for aortic valve replacement (42% women, 73 ± 9 years, mean aortic gradient 51 ± 18 mm Hg, and left ventricular ejection fraction 61 ± 11%) undergoing either isolated aortic valve replacement (58%) or combined to bypass grafting. Both plasma BNP and logES was estimated before surgery. The median BNP plasma level and logES were 157 pg/ml (interquartile range [IQR] 61 to 440) and 6.6% (IQR 4.2 to 12.2), respectively. The perioperative mortality was 6% and the overall mortality by the end of the study was 13%. Patients with logES >10.1% (upper tertile) had a higher risk of dying over time (hazard ratio [HR] 2.86, p = 0.037), as had patients with BNP >312 pg/ml (HR 9.01, p

Original languageEnglish
Pages (from-to)749-754
Number of pages6
JournalThe American Journal of Cardiology
Volume102
Issue number6
DOIs
Publication statusPublished - Sep 15 2008

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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