Cardiac Biomarkers in Patients With Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial

Figures

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  Figure 1.. Kaplan-Meier curves for the key clinical outcomes according to NT-proBNP and hs-cTnT tertiles. Kaplan-Meier curves for the composites of all-cause death, all stroke, or unplanned cardiovascular hospitalization: A, NT-proBNP (N-terminal pro–B-type natriuretic peptide); B, hs-cTnT (high-sensitivity cardiac troponin T); all-cause death, all stroke, or heart failure (HF) hospitalization; C, NT-proBNP; D, hs-cTnT; all-cause death, all stroke, unplanned cardiovascular hospitalization, or intervention or reintervention with advanced signs or symptoms; E, NT-proBNP; F, hs-cTnT; and HF hospitalization; G, NT-proBNP; and H, hs-cTnT. The insets in E and F show the same data on an enlarged y axis. P value shown is based on an unadjusted log-rank test with data up to 5 years. Tertile 1 is shown in green, tertile 2 is shown in blue, and tertile 3 is shown in red.

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  Figure 2.. Forest plot showing key clinical outcome event rates and treatment effect according to NT-proBNP and hs-cTnT tertiles. Forest plot showing key clinical outcome event rates and treatment effect according to NT-proBNP (N-terminal pro–B-type natriuretic peptide; A) or hs-cTnT (high-sensitivity cardiac troponin T; B) tertiles. Clinical event incidence (n/N) and Kaplan-Meier rates, rates per 100 patient-years, number needed to treat, risk, and interaction P values are shown for all-cause death, all stroke, or unplanned cardiovascular hospitalization; all-cause death, all stroke, or heart failure hospitalization; all-cause death, all stroke, unplanned cardiovascular hospitalization, or intervention or reintervention with advanced signs or symptoms; all-cause death or heart failure hospitalization; and heart failure hospitalization according to all patients included in the biomarker analysis (n=798) and tertiles 1, 2, or 3 for NT-proBNP (A) or hs-cTnT (B) levels. Number needed to treat values are presented when transcatheter aortic valve replacement (TAVR) has a statistically significantly lower hazard ratio (HR) compared with clinical surveillance (CS). Clinical event HRs and 95%…

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  Figure 3.. Forest plot showing key clinical outcome event rates and treatment effect according to elevated vs normal NT-proBNP and hs-cTnT levels. Forest plot showing key clinical outcome event rates and treatment effect according to elevated vs normal NT-proBNP (N-terminal pro–B-type natriuretic peptide; A) or hs-cTnT (high-sensitivity cardiac troponin T; B) levels. Clinical event incidence (n/N) and Kaplan-Meier rates, rates per 100 patient-years, number needed to treat, risk, and interaction P values are shown for all-cause death, all stroke, or unplanned cardiovascular hospitalization; all-cause death, all stroke, or heart failure hospitalization; all-cause death, all stroke, unplanned cardiovascular hospitalization, or intervention or reintervention with advanced signs or symptoms; all-cause death or heart failure hospitalization; and heart failure hospitalization according to all patients included in the biomarker analysis (n=798) and elevated vs normal levels of NT-proBNP (A) or hs-cTnT (B) levels. Number needed to treat values are presented when transcatheter aortic valve replacement (TAVR) has a statistically significantly lower hazard ratio (HR) compared with clinical surveillance…

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  Figure 4.. Forest plot showing key clinical outcome event rates and treatment effect according to NT-proBNP level ≤3-fold elevated vs >3-fold elevated. Clinical event incidence (n/N) and Kaplan-Meier rates, rates per 100 patient-years, number needed to treat, risk, and interaction P values are shown for all-cause death; all stroke or unplanned cardiovascular hospitalization; all-cause death, all stroke, or heart failure hospitalization; all-cause death, all stroke, unplanned cardiovascular hospitalization, or intervention or reintervention with advanced signs or symptoms; and heart failure hospitalization according to all patients included in the biomarker analysis (n=798), ≤3-fold elevated NT-proBNP (N-terminal pro–B-type natriuretic peptide) level (n=646), and >3-fold elevated NT-proBNP level (n=152). Number needed to treat values are presented when transcatheter aortic valve replacement (TAVR) has statistically significantly lower hazard ratio (HR) compared with clinical surveillance (CS). Clinical event HRs and 95% confidence limits are based on Cox proportional hazard models with data up to 5 years. Interaction P values (Pinteraction) reflect interactions between the tertile and…

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  Figure 5.. Timing and clinical presentation class of AVR conversion in the CS arm according to biomarker tertiles. A, Kaplan-Meier curves for the timing of conversion to aortic valve replacement (AVR) in patients randomized to the clinical surveillance (CS) arm according to tertile of NT-proBNP (N-terminal pro–B-type natriuretic peptide; left) and hs-cTnT (high-sensitivity cardiac troponin T; right). The median time to conversion and interquartile range (in days) by tertile is shown on each curve. Tertile 1 is shown in green, tertile 2 is shown in blue, and tertile 3 is shown in red. B, Stacked bar graphs showing the clinical presentation class at time of AVR conversion by NT-proBNP and hs-cTnT tertiles in patients randomized to the CS arm. P values shown are based on Jonckheere-Terpstra trend tests.