Utility of High-Sensitivity Cardiac Troponin-T and N-Terminal Pro-B-Type Natriuretic Peptide to Predict Survival, Quality of Life, and Functional Status Changes After Transcatheter Aortic Valve Implantation
Recommended Citation
Andrews T, Jabri A, McBride P, Gelovani D, Beidoun M, Giustino G, Krafchak S, Gladney S, Holmes D, Wyman JF, Wang DD, Eng M, Aronow H, Lanfear D, O'Neill W, Engel Gonzalez P, O'Neill B, Villablanca P, Lee J, Jacobsen G, Cook B, McCord J, and Frisoli TM. Utility of High-Sensitivity Cardiac Troponin-T and N-Terminal Pro-B-Type Natriuretic Peptide to Predict Survival, Quality of Life, and Functional Status Changes After Transcatheter Aortic Valve Implantation. J Am Heart Assoc 2025;e039898.
Document Type
Article
Publication Date
11-4-2025
Publication Title
J Am Heart Assoc
Keywords
Humans, Transcatheter Aortic Valve Replacement, Natriuretic Peptide, Brain, Male, Female, Peptide Fragments, Troponin T, Aortic Valve Stenosis, Biomarkers, Quality of Life, Prospective Studies, Aged, 80 and over, Aged, Functional Status, Predictive Value of Tests, Survival Rate, Time Factors
Abstract
BACKGROUND: Cardiac biomarkers are minimally incorporated into current aortic valve guidelines, except for elevated BNP (B-type natriuretic peptide) in asymptomatic severe aortic stenosis. This prospective observational cohort studied how pretranscatheter aortic valve implantation (TAVI) NT-proBNP (N-terminal proBNP) and hs-cTnT (high-sensitivity cardiac troponin T) relate to mortality, quality of life, and functional outcomes after TAVI.
METHODS: This is a prospective cohort study of 173 patients undergoing TAVI at a large medical center in the United States between January 1, 2020, and January 1, 2022. NT-pro-BNP and hs-cTnT, Kansas City Cardiomyopathy Questionnaire, 6-minute walk distance, and mortality were surveilled pre TAVI, and at 30 days, 1 year, and 2 years post TAVI. The patients represented a real-world cohort of patients receiving TAVI.
RESULTS: Two-year mortality for the entire cohort was 7.51% (13/173). In univariable analysis, higher baseline NT-pro-BNP and hs-cTnT were predictors of mortality at 2 years after TAVI. After adjusting for covariables, baseline hs-cTnT demonstrated a clinically meaningful association with mortality (P=0.058; odds ratio [OR], 2.74 [95% CI, 0.967-7.734]). In multivariable analysis, a combination variable of tertiled baseline hs-cTnT and NT-pro-BNP was a significant predictor of 2-year mortality; specifically, 2-year mortality rates stratified by combined score values of 6, 5, 4, 3, and 2 were 16.1%, 13.8%, 7.3%, 0%, and 0%, respectively.
CONCLUSIONS: Those with an elevated combination biomarker variable-NT-pro-BNP >357 pg/mL and hs-cTnT >14.1 ng/L-should be most rigorously surveilled and managed before and after TAVI with more frequent and comprehensive outpatient visits for medical optimization of cardiac and noncardiac disease states.
Medical Subject Headings
Humans; Transcatheter Aortic Valve Replacement; Natriuretic Peptide, Brain; Male; Female; Peptide Fragments; Troponin T; Aortic Valve Stenosis; Biomarkers; Quality of Life; Prospective Studies; Aged, 80 and over; Aged; Functional Status; Predictive Value of Tests; Survival Rate; Time Factors
PubMed ID
41128137
ePublication
ePub ahead of print
Volume
14
Issue
21
First Page
039898
Last Page
039898
