{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:16:03Z","timestamp":1792556163448,"version":"4.5.0"},"reference-count":85,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T00:00:00Z","timestamp":1621209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>The optimal timing of aortic valve replacement (AVR) remains controversial. Several biomarkers reflect the underlying pathophysiological processes in aortic stenosis (AS) and may be of use as mortality predictors. The aim of this systematic review and meta-analysis is to evaluate the blood biomarkers utilised in AS and assess whether they associate with mortality. PubMed and Embase were searched for studies reporting baseline biomarker level and mortality outcomes in patients with AS. A total of 83 studies met the inclusion criteria and were systematically reviewed. Of these, 21 reporting brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), Troponin and Galectin-3 were meta-analysed. Pooled analysis demonstrated that all-cause mortality was significantly associated with elevated baseline levels of BNP (HR 2.59; 95% CI 1.95\u20133.44; p &lt; 0.00001), NT-proBNP (HR 1.73; 95% CI 1.45\u20132.06; p = 0.00001), Troponin (HR 1.65; 95% CI 1.31\u20132.07; p &lt; 0.0001) and Galectin-3 (HR 1.82; 95% CI 1.27\u20132.61; p &lt; 0.001) compared to lower baseline biomarker levels. Elevated levels of baseline BNP, NT-proBNP, Troponin and Galectin-3 were associated with increased all-cause mortality in a population of patients with AS. Therefore, a change in biomarker level could be considered to refine optimal timing of intervention. The results of this meta-analysis highlight the importance of biomarkers in risk stratification of AS, regardless of symptom status.<\/jats:p>","DOI":"10.3390\/medsci9020029","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T12:19:57Z","timestamp":1621253997000},"page":"29","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"9","author":[{"given":"Madeline","family":"White","sequence":"first","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranu","family":"Baral","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisdair","family":"Ryding","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1534-7587","authenticated-orcid":false,"given":"Vasiliki","family":"Tsampasian","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuwarahan","family":"Ravindrarajah","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5483-169X","authenticated-orcid":false,"given":"Pankaj","family":"Garg","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos C.","family":"Koskinas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Freiburgstrasse 18, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Clark","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-7752","authenticated-orcid":false,"given":"Vassilios S.","family":"Vassiliou","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK"},{"name":"Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Zakkar, M., Bryan, A.J., and Angelini, G.D. 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