Association of NT-proBNP and 7-day mortality of patients with acute ischemic stroke in intensive care unit: a retrospective cohort study

Abstract

Acute ischemic stroke (AIS) results in high mortality, especially among patients admitted to the intensive care unit. Previous research has shown the relationship of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with stroke. However, unlike in heart disease, few research has related NT-proBNP with severity and prognosis of patients with AIS in the intensive care unit. This study aimed to investigate the relation between NT-proBNP, which is widely used in heart disease, and the short-term mortality of patients with AIS in critical care unit. This retrospective study was based on Medical Information Mart for Intensive Care (MIMIC)-IV. The main outcome was defined as mortality in seven days and the secondary outcomes were defined as ventricular tachycardia and performance of endotracheal tube. Patients diagnosed with acute ischemic stroke and acute cerebral infarction were extracted based on the 9th and 10th versions of ICD codes. If the patient was treated multiple times in the ICU, only the data of the first admission to the ICU will be taken for research and analysis. The level of NT-proBNP was significantly associated with 7-day all-cause mortality in patients with AIS, the HR was 1.84 ([95% CI, 1.11–3.07], P = 0.019). After excluding patients with heart failure, NT-proBNP showed significant association with 7-day all-cause mortality, the HR was 2.71 ([95% CI, 1.15–6.37], P = 0.022). There was no significant association between NT-proBNP and secondary outcomes. In patients with AIS in intensive care unit, higher levels of NT-proBNP related with a higher mortality. NT-proBNP might serve as a biomarker that help to predict the short-term mortality among the patients with AIS in intensive care unit.