NT-proBNP and postoperative heart failure in surgery for aortic stenosis

Figures

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  Figure 1. NT-proBNP levels (ng/L) before and after surgery in patients with PHF (black bars) and without PHF (white bars). Data are expressed as median with IQR; *p<0.05. 6 months postop, 6-month follow-up; NT-proBNP, N-terminal pro-B-type natriuretic peptide; PHF, postoperative heart failure; POD1, first postoperative day; POD3, third postoperative day; PREEV, preoperative evaluation; PREOP, the day before the index procedure.

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  Figure 2. Discrimination of perioperative NT-proBNP for postoperative heart failure (PHF) in patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS). According to receiver operating characteristic analyses, the NT-proBNP level on the first postoperative day (POD1) demonstrated good discrimination for PHF in patients undergoing AVR for AS (area under the curve (AUC)=0.82, 95% CI 0.72 to 0.91, p<0.0001; best cut-off 5290 ng/L with a sensitivity of 63% and a specificity of 85%), whereas the discrimination of NT-proBNP for PHF was less convincing on the day before the index procedure (PREOP) and on the third postoperative day (POD3) (PREOP: AUC=0.61, 95% CI 0.44 to 0.78, p=0.14; POD3: AUC=0.63, 95% CI 0.49 to 0.77, p=0.08). NT-proBNP, N-terminal pro-B-type natriuretic peptide.

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  Figure 3. Cumulative survival (Kaplan-Meier) for patients with (dashed line) or without (solid line) postoperative heart failure (PHF).

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  Figure 4. Cumulative survival (Kaplan-Meier) for patients with an NT-proBNP level ≥5290 ng/L (dashed line) or <5290 ng/L (solid line) on POD1. NT-proBNP, N-terminal pro-B-type natriuretic peptide; POD1, first postoperative day.

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  Figure 5. Cumulative survival (Kaplan-Meier) in the subgroup with PHF for patients with an NT-proBNP level ≥5290 ng/L (dashed line) or <5290 ng/L (solid line) on POD1. The NT-proBNP level on POD1 was missing in two patients (one died 6 years after surgery, the other one was alive 7 years after surgery). NT-proBNP, N-terminal pro-B-type natriuretic peptide; PHF, postoperative heart failure; POD1, first postoperative day.