Association between increased N-terminal pro-brain natriuretic peptide level and poor clinical outcomes after acute ischemic stroke.

Abstract

BACKGROUND AND PURPOSE:

N-terminal pro-brain natriuretic peptide (NT-proBNP) has been shown to be associated with the prognosis of cardiovascular diseases and NT-proBNP level is elevated in patients with acute ischemic stroke. However, the association between NT-proBNP and poor prognosis after ischemic stroke is still uncertain. The aim of this study was to examine whether serum NT-proBNP is associated with global clinical outcomes in a large cohort of patients with acute ischemic stroke.

METHODS:

Baseline serum NT-proBNP level was measured in a subset of 3126 patients with acute ischemic stroke, and the patients were followed up to assess their clinical outcomes within 1year after the stroke. Cox proportional hazard models and logistic regression models were used to assess the effects of NT-proBNP on the primary outcome (composite outcome of death and vascular events) and poor functional outcomes.

RESULTS:

During 1year of follow-up, 278 (9.0%) patients with a primary outcome and 685 (22.1%) patients with a poor functional outcome were identified. The cumulative incidence of primary outcomes increased across serum NT-proBNP quartiles (log-rank P<0.001). Hazard ratios (95% confidence interval) of the highest quartile compared with the lowest quartile were 1.47 (1.01-2.13) for the primary outcome, 1.79 (1.07-2.98) for death after multivariable adjustment. In addition, serum NT-proBNP was also associated with poor functional outcomes (odds ratio, 1.47; 95% confidence interval, 1.11-1.94; Ptrend=0.008).

CONCLUSIONS:

This study showed that high NT-proBNP levels increased the risk of a composite outcome of death and vascular events and poor functional outcomes at 1year after stroke onset among ischemic stroke patients with elevated blood pressure, suggesting that NT-proBNP might be a potential prognostic factor for ischemic stroke.

• Authors: Jingyuan Yang, Chongke Zhong, Aili Wang, Tan Xu, Xiaoqing Bu, Yanbo Peng, Jinchao Wang, Hao Peng, Qunwei Li, Zhong Ju, Deqin Geng, Yonghong Zhang, Jiang He, on behalf for the CATIS Investigation Groups
• Journal: Journal of the neurological sciences (J Neurol Sci) Vol. 383 Pg. 5-10 (Dec 15 2017) ISSN: 1878-5883 [Electronic] Netherlands
• PMID: 29246621 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2017 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• N-terminal proatrial natriuretic peptide
• Protein Precursors
• Atrial Natriuretic Factor

Topics

• Atrial Natriuretic Factor (blood)
• Biomarkers (blood)
• Brain Ischemia (blood, mortality, therapy)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Prognosis
• Proportional Hazards Models
• Protein Precursors (blood)
• Stroke (blood, mortality, therapy)
• Treatment Outcome