Early Midregional Pro-Atrial Natriuretic Peptide Predicts the Occurrence of Atrial Fibrillation in Stroke Patients: Data From the Biosignal Study

Abstract

for the BIOSIGNAL investigators Methods • In this prospective, multicenter cohort study (2014)(2015)(2016)(2017) we measured MR-pro ANP in ischemic stroke patients within 24h of symptoms onset. (By a sandwich immunoassay (BRAHMS AG, Berlin). • Univariate and multivariate logistic regression models were fitted to estimate odds ratios for the magnitude and independence of the association of MR-proANP with each outcome measure. Background• The use of rapidly measurable blood biomarkers may advance the identification of patients with underlying atrial cardiopathy, who may benefit more from direct oral anticoagulants compared to antiplatelets for secondary prevention. • The objective of this study was to assess the incremental value of midregional pro-Atrial Natriuretic Peptide (MR-proANP) in identifying cardio-embolic stroke (CE stroke according to the TOAST criteria), newly diagnosed atrial fibrillation (AF) during hospitalization and on follow-up as well as recurrent vascular events after ischemic stroke. ResultsConclusions MR-proANP is an independent marker for cardio-embolic stroke etiology according to the TOAST criteria, newly detected atrial fibrillation and cardiovascular events up to one year after the index stroke. Therefore MR-proANP seems to be a good candidate to select patients for prolonged rhythm monitoring in clinical routine or even for oral anticoagulation in a randomized controlled trial.