Abstract 2788: Combined Evaluation Of Circulating Platelet Derived Microparticles And Brain Natriuretic Peptide Is A Novel Predictor For The Occurrence Of Cardioembolic Stroke
Introduction: It is well known that plasma levels of brain natriuretic peptide (BNP) reflect left ventricular diastolic function in cases with structural heart diseases. We previously reported that systemic platelet activation might play an important role in the left atrial appendage (LAA) thrombus formation in cases with cardioembolic stroke, which is resistant to anti-coagulant treatment.
Hypothesis: Combined measurement of circulating levels of platelet derived microparticles (PDMP) and BNP is a sensitive predictor for LAA thrombus formation.
Metods: Trans-thoracic and esophageal echocardiographic findings, serum hemostatic markers, PDMP, and BNP were examined in 80 cases with ischemic stroke within 7 days after the onset (male, n=52, 68±13 years old; female, n=28, 70±13 yo). No patients had history of chronic heart failure and/or ischemic heart diseases.
Results: There were no significant differences in left ventricular end-diastolic dimension (LVDd), and the ratio of the early diastolic trans-mitral inflow velocity (E) to mitral annular velocity (E’) between cases with LAA thrombus (n=11) and no thrombus (LVDd, 49±6 vs. 48±6 mm; E/E’, 8.6±1.3 vs. 7.2±0.9). The circulating PDMP and BNP levels were markedly higher in cases with LAA thrombus formation than in those without it (PDMP, 131±72 vs. 89±59 U/ml, P<0.05; BNP, 229±220 vs. 79±87 pg/ml, P<0.01). In LAA thrombus negative group, the BNP levels were significantly correlated well with LAA peak emptying flow velocity (R=-0.43, P<0.01). The multivariate logistic regression analysis showed that the combination of PDMP >92 and BNP >120 was an independent predictor of LAA thrombus formation (Odds ratio, 19.50; 95% confidence interval, 4.104 –92.645; P=0.0002).
Conclusion: Combined evaluation of PDMP and BNP concentrations at acute period could use as a surrogate maker to predict LAA dysfunction and thrombus formation in patients with ischemic stroke.