Abstract 5826: B-type Natriuretic Peptide Predicts Mortality In Patients With Acute Ischemic Stroke
Background: B-type natriuretic peptide (BNP) has been identified as a useful biomarker in diagnosing heart failure and in providing prognostic information after myocardial infarction. In some studies, the elevation of BNP was associated with acute ischemic stroke. But prognostic value of BNP among patients with acute ischemic stroke was not established.
Methods: We included consecutively 372 patients with acute ischemic stroke who underwent a comprehensive clinical examination and measurements of BNP, cardiac enzyme, and other biomarkers. Echocardiography was performed after stabilization to evaluate cardiac embolism. We evaluated the usefulness of BNP to detect cardiovascular diseases such as heart failure and ischemic heart disease, and mortality. The patients were followed-up for 17.4±7.1 months.
Results: Of the 372 patients with acute ischemic stroke (mean age 65±13; female 44%), heart failure and ischemic heart disease were diagnosed in 16 (4.3%) and 20 patients (5.4%), respectively during admission. BNP plasma levels in the patients with heart failure (367±295 pg/ml, p < 0.001) or ischemic heart diseases (358±329 pg/ml, p < 0.001) were higher than in the patients without cardiac events (72±116 pg/ml). There was no significant difference in hsCRP, troponin, homocystein and lipoprotein (a) between patients with or without cardiac events. BNP remained a marker of cardiac events after adjustment for other variables, including age, sex, and atrial fibrillation. Multivariate analysis demonstrated that age and increased BNP (more than 100 pg/ml) were the 2 strongest independent predictors for mortality (odds ratio (OR) 1.09, p = 0.001; OR 5.7, p = 0.002, respectively).
Conclusions: In patients admitted with acute ischemic stroke, BNP may be useful to identify cardiac events such as heart failure and ischemic
This research has received full or partial funding support from the American Heart Association, National Center.