Predictive value of serum initial brain natriuretic peptide and troponin on functional prognosis in noncardiogenic patients with anterior and posterior circulation cerebral infarction

Abstract

Background Brain natriuretic peptide (BNP) and troponin have a close relationship with cardiogenic cerebral embolism (CCE), but their relationship with noncardiogenic patients with anterior circulation ischemia (ACI) and posterior circulation ischemia (PCI) is not clear. Objective To explore the predictive value of serum initial BNP and troponin on the functional prognosis of patients with noncardiogenic ACI and PCI. Methods Consecutive patients with first-episode cerebral infarction within 12 hours of symptom onset were enrolled in the present 1-year prospective cohort study. Serum levels of BNP and troponin were collected within 12 hours of onset. Infarction location was classified as ACI and PCI by magnetic resonance imaging (MRI). According to the modified Rankin Scale (mRS) score at 90 days after onset, ACI and PCI cases were respectively divided into a good prognosis group (mRS score between 0 and 2) and a poor prognosis group (mRS score between 3 and 6). The general state of health and results of laboratory examinations and other auxiliary examinations of all patients were recorded. Single-factor analysis and multivariate logistic regression analysis were used to assess the relationship between serum levels of BNP, troponin, and functional outcome. Results The multivariate logistic regression found that higher levels of initial BNP (odds ratio [OR] = 1.024; 95% confidence interval [CI]: 1.006–1.041; p = 0.007) and C-reactive protein (CRP) (OR = 1.184; 95%CI: 1.024–1.369; p = 0.022) were independent predictors of poor functional prognosis of noncardiogenic PCI at 90 days after onset after adjusting for age, gender, ethnicity, history of hypertension and of diabetes. Conclusions The levels of initial BNP and CRP were related to poor functional outcomes in noncardiogenic PCI patients at 3 months, independent of troponin.

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

“…As coronary heart disease is the most common form of heart disease [ 30 ] and is of atherosclerotic origin, this may explain why we did not find any significant difference in BNP and NT-proBNP expression in AIS clots of LAA and CE etiology. In line with this, several recent studies associated high BNP/NT-pro BNP plasma levels with a higher risk of thrombotic events, although not only of cardioembolic etiology [ 31 , 32 , 33 , 34 ].…”

Atuação de biomarcadores sob lesão endotelial e neuronal no Acidente Vascular Cerebral Isquêmico (AVCi): uma revisão de literatura

“…Ao se analisar os sintomas clínicos e a neuroimagem, a isquemia da circulação anterior (ICA) indica isquemia da artéria cerebral média e do sistema da artéria cerebral anterior, enquanto a isquemia da circulação posterior (ICP) é definida como infarto isquêmico da área do sistema arterial vertebrobasilar que supre a metade posterior do hemisfério cerebral, o intercérebro, o tronco cerebral (48%) e o cerebelo. Assim, devido à diferente anatomia vascular e fácil localização de embolização dos sistemas circulatório posterior e anterior, suas características clínicas, etiologia e fatores prognósticos também são diversos (Lu et al, 2023).…”

“…Research, Society and Development, v. 12, n. 6, e6712641951, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i6.41951 7 Assim, de acordo com o autor anteriormente referido, estudos mostraram que a embolização não cardiogênica pode ser a principal causa de infarto cerebral de circulação posterior, diferentemente da principal causa de infarto cerebral de circulação anterior. Portanto, mais estudos são necessários para elucidação quanto às possibilidades em relação a etiologia (Lu et al, 2023).…”