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

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.