BNPratio predicts mortality in degenerative mitral regurgitation
(HealthDay)—The ratio of B-type natriuretic peptide (BNP) to upper limit of normal for age, sex, and assay (BNPratio) predicts long-term mortality for patients with mitral regurgitation (MR) who undergo medical management, according to a study published in the Sept. 20 issue of the Journal of the American College of Cardiology.
Marie-Annick Clavel, Ph.D., from the Mayo Clinic in Rochester, Minn., and colleagues examined the effect of BNP activation on mortality in a multicenter cohort of 1,331 patients with degenerative MR. BNP was measured at diagnosis and expressed as BNPratio. In 561 patients, initial surgical management was performed within three months of diagnosis.
The researchers found that the median BNPratio was 1.01, and was an independent predictor of mortality (hazard ratio, 1.33; P < 0.0001), while absolute BNP was not (P = 0.43). For the 770 patients who were initially treated medically, BNPratio was an independent and incremental predictor of mortality after diagnosis (hazard ratio, 1.61; P < 0.0001). There was a correlation for higher BNP activation with higher mortality (P < 0.0001). Similar excess mortality was seen with BNP activation for all subgroups, especially severe MR. BNP activation did not impose excess long-term mortality after initial surgical treatment (P = 0.23).
"In patients with degenerative MR, BNPratio is a powerful, independent, and incremental predictor of long-term mortality under medical management," the authors write. "BNPratio should be incorporated into the routine clinical assessment of patients with degenerative MR."
Two authors disclosed financial ties to the pharmaceutical and medical device industries.
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