Elevated NT-proBNP levels are associated with CTP ischemic volume and 90-day functional outcomes in acute ischemic stroke: a retrospective cohort study

Shen, Xiaozhu; Liao, Juan; Jiang, Yi; Xu, Yiwen; Liu, Mengqian; Zhang, Xianxian; Dong, Nan; Yu, Liqiang; Chen, Qingmei; Fang, Qi

doi:10.1186/s12872-022-02861-w

Cited by 5 publications

(6 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The BNP levels were shown to negatively correlate with a favorable outcome within 24 h of stroke onset [ 41 ]. Recent studies suggested that BNP and NT-proBNP may have use in predicting stroke risk in patients with heart failure with preserved ejection fraction [ 42 ], prognostic potential for functional outcome after AIS [ 43 , 44 ], and use in optimizing the management of stroke associated to heart disease [ 45 ]. Further work correlating BNP and NT-proBNP expression in AIS clots with longer-term patient outcome measures of stroke severity could yield further interesting insights.…”

Section: Discussionmentioning

confidence: 99%

Investigating the Role of Brain Natriuretic Peptide (BNP) and N-Terminal-proBNP in Thrombosis and Acute Ischemic Stroke Etiology

Rossi,

Jabrah,

Douglas

et al. 2024

IJMS

View full text Add to dashboard Cite

The need for biomarkers for acute ischemic stroke (AIS) to understand the mechanisms implicated in pathological clot formation is critical. The levels of the brain natriuretic peptides known as brain natriuretic peptide (BNP) and NT-proBNP have been shown to be increased in patients suffering from heart failure and other heart conditions. We measured their expression in AIS clots of cardioembolic (CE) and large artery atherosclerosis (LAA) etiology, evaluating their location inside the clots, aiming to uncover their possible role in thrombosis. We analyzed 80 thrombi from 80 AIS patients in the RESTORE registry of AIS clots, 40 of which were of CE and 40 of LAA etiology. The localization of BNP and NT-BNP, quantified using immunohistochemistry and immunofluorescence, in AIS-associated white blood cell subtypes was also investigated. We found a statistically significant positive correlation between BNP and NT-proBNP expression levels (Spearman’s rho = 0.668 p < 0.0001 *). We did not observe any statistically significant difference between LAA and CE clots in BNP expression (0.66 [0.13–3.54]% vs. 0.53 [0.14–3.07]%, p = 0.923) or in NT-proBNP expression (0.29 [0.11–0.58]% vs. 0.18 [0.05–0.51]%, p = 0.119), although there was a trend of higher NT-proBNP expression in the LAA clots. It was noticeable that BNP was distributed throughout the thrombus and especially within platelet-rich regions. However, NT-proBNP colocalized with neutrophils, macrophages, and T-lymphocytes, suggesting its association with the thrombo-inflammatory process.

show abstract

Section: Discussionmentioning

confidence: 99%

Investigating the Role of Brain Natriuretic Peptide (BNP) and N-Terminal-proBNP in Thrombosis and Acute Ischemic Stroke Etiology

Rossi,

Jabrah,

Douglas

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

“…For instance, a metaanalysis concluded that PTFV1 is an independent predictor of IS 9) ; however, a subsequent prospective study questioned its reliability 10) . Similarly, while NT-pro BNP has been identified as useful for predicting the functional outcomes and mortality in AIS patients 11,12) , other studies have found that elevated levels of NT-pro BNP do not necessarily correlate with the 3-month mortality in AIS patients who do not show any obvious myocardial damage 13) . Additionally, some evidence suggests that composite indicators of the myocardial function may offer a more nuanced prognostic value than single markers 14) .…”

Section: Discussionmentioning

confidence: 99%

“…While previous large-scale studies have indicated the significance of ACM markers in gauging the risk of adverse cardiac events, such as atrial fibrillation (AF) 22,23) , myocardial infarction (MI) 24,25) , and HF 26) , their role in st roke prognosis remains underexplored. Several small-sample retrospective studies have found that some ACM-related markers are associated with death and disability after IS 11,12) . However, some results remain controversial in different research contexts 13) .…”

Section: Survival Analysis Of Acm In Patients With Noncardioembolic S...mentioning

confidence: 99%

Atrial Cardiomyopathy Predicts the Functional Outcome and Mortality in Stroke Patients

Liu,

Wang,

Ding

et al. 2024

JAT

View full text Add to dashboard Cite

Aim: Atrial cardiomyopathy (ACM) is characterized by atrial dysfunction. This study aims to assess the prognostic significance of ACM in patients with noncardioembolic stroke (NCS). Methods: Patients with NCS within seven days of onset were prospectively enrolled between January 2019 and December 2020. ACM was defined as either an N-terminal pro-brain natriuretic peptide (NT-pro BNP) ＞250 pg/ml or a P-terminal force in precordial lead V1 (PTFV1) ≥ 5000μV•ms. A poo r functional outcome was determined as a score of 3-6 on the modified Rankin Scale (mRS) within a 2-year follow-up period. Logistic regression and Cox regression analyses were employed to examine the relationship between ACM and the longterm prognosis of patients with NCS. Results: A total of 1,346 patients were enrolled, of whom 299 (22.2%) patients were diagnosed with ACM. A total of 207(15.4%) patients experienced a poor functional outcome, and 58 (4.3%) patients died. A multivariate logistic regression analysis indicated that ACM was significantly associated with a poor functional outcome in NCS patients [adjusted odds ratio (aOR): 2.01; 95% confidence interval (CI): 1.42-2.87; p＜0.001]. Additionally, a multivariate Cox regression analysis showed that an NT-pro BNP ＞250 pg/ml was significantly associated with an increased risk of all-cause mortality [adjusted hazard ratio (aHR), 2.51; 95% CI: 1.42-4.43; p=0.001].Conclusions: ACM may serve as a novel predictor of a poor long-term functional outcome in patients with NCS. Elevated NT-pro BNP levels (＞250 pg/ml) were found to be associated with a higher risk of all-cause mortality. These findings warrant further validation in multicenter studies.

show abstract

“…Second, high NT-proBNP levels might indicate an underlying atrial fibrillation in ischemic stroke patients, who remained cryptogenic after the initial workup. 21 As (untreated) cardioembolic stroke etiology has a high rate of recurrent vascular events and often leads to severe stroke syndromes with larger infarct size, 1,27 this could in part explain the higher rate of post-stroke mortality in patients with high NT-proBNP levels at admission. These considerations are further supported by a trend toward a higher number of recurrent vascular events in patients with NT-proBNP levels above 794 pg/mL in our cohort.…”

Section: Discussionmentioning

confidence: 99%

The value of clinical routine blood biomarkers in predicting long-term mortality after stroke

Hatab

Kneihsl

Bisping

et al. 2023

European Stroke Journal

View full text Add to dashboard Cite

Background: Several blood biomarkers have been identified as predictors for poor outcome after ischemic stroke. However, recent studies mainly focused on single or experimental biomarkers and considered rather short follow-up intervals limiting their value for daily clinical practice. We, therefore, aimed to compare various clinical routine blood biomarkers for their predictive value on post-stroke mortality over a 5-year follow-up period. Patients and methods: This data analysis of a prospective single-center study included all consecutive ischemic stroke patients admitted to the stroke unit of our university hospital over a 1-year period. Various blood biomarkers of inflammation, heart failure, metabolic disorders, and coagulation were analyzed from standardized routine blood samples collected within 24 h of hospital admission. All patients underwent a thorough diagnostic workup and were followed for 5 years post-stroke. Results: Of 405 patients (mean age: 70.3 years), 72 deceased (17.8%) during the follow-up period. While various routine blood biomarkers were associated with post-stroke mortality in univariable analyses, only NT-proBNP remained an independent predictor (adjusted odds ratio 5.1; 95% CI 2.0–13.1; p < 0.001) for death after stroke. NT-proBNP levels ⩾794 pg/mL ( n = 169, 42%) had a sensitivity of 90% for post-stroke mortality with a negative predictive value of 97% and was additionally associated with cardioembolic stroke and heart failure (each p ⩽ 0.05). Conclusion: NT-proBNP represents the most relevant routine blood-based biomarker for the prediction of long-term mortality after ischemic stroke. Increased NT-proBNP levels indicate a vulnerable subgroup of stroke patients in which early and thorough cardiovascular assessment and consistent follow-ups could improve outcome after stroke.

show abstract

Elevated NT-proBNP levels are associated with CTP ischemic volume and 90-day functional outcomes in acute ischemic stroke: a retrospective cohort study

Cited by 5 publications

References 51 publications

Investigating the Role of Brain Natriuretic Peptide (BNP) and N-Terminal-proBNP in Thrombosis and Acute Ischemic Stroke Etiology

Investigating the Role of Brain Natriuretic Peptide (BNP) and N-Terminal-proBNP in Thrombosis and Acute Ischemic Stroke Etiology

Atrial Cardiomyopathy Predicts the Functional Outcome and Mortality in Stroke Patients

The value of clinical routine blood biomarkers in predicting long-term mortality after stroke

Contact Info

Product

Resources

About