Association between different biomarkers and mortality in moderate or asymptomatic severe aortic stenosis: A systematic review

Medicina clinica (English ed.) Pub Date : 2026-06-01 Epub Date: 2026-06-13 DOI:10.1016/j.medcle.2026.107408

José Agostinho Carneiro , Ana Rute Costa , Carla Araújo

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Abstract

Circulating biomarkers may enhance risk stratification and guide treatment in diseases with heterogeneous prognosis, namely in moderate and asymptomatic severe aortic stenosis (AS). Therefore, this study aims to assess the association between biomarkers and mortality in patients with these diseases. MEDLINE, Web of Science, and Scopus were searched from inception up to January 2025. Cohort studies evaluating BNP, NT-proBNP, troponin, galectin-3 or ST2, before aortic valve replacement, and reporting mortality outcomes, were eligible. Two independent reviewers performed screening, data extraction and quality assessment. A total of ten studies were included: five focused on BNP and the other five on NT-proBNP. Despite methodological heterogeneity and a high risk of bias in most studies, a positive association was observed between high levels of these biomarkers and mortality. Further research should ascertain biomarkers’ standardized thresholds, as well as the prognostic role of other biomarkers in this population.

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不同生物标志物与中度或无症状重度主动脉瓣狭窄患者死亡率之间的关系：一项系统综述

循环生物标志物可增强预后不均匀疾病的风险分层和指导治疗，即中度和无症状重度主动脉瓣狭窄（AS）。因此，本研究旨在评估这些疾病患者的生物标志物与死亡率之间的关系。MEDLINE， Web of Science和Scopus从成立到2025年1月进行了检索。在主动脉瓣置换术前评估BNP、NT-proBNP、肌钙蛋白、半乳糖凝集素-3或ST2并报告死亡率结果的队列研究符合条件。两名独立评审员进行筛选、数据提取和质量评估。共纳入10项研究：5项关注BNP，另外5项关注NT-proBNP。尽管在大多数研究中存在方法学上的异质性和高偏倚风险，但观察到这些生物标志物的高水平与死亡率之间存在正相关。进一步的研究应该确定生物标志物的标准化阈值，以及其他生物标志物在该人群中的预后作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Medicina clinica (English ed.)

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