NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack.

Abstract

BACKGROUND:

Elevated levels of B-type natriuretic peptide (BNP) and NT-pro-BNP can predict an increased risk of cardiovascular events and ischemic stroke. The limited reliability to predict the risk of stroke after a transient ischemic attack (TIA) justifies the objective of our study to determine the role of NT-pro-BNP in patients with TIAs.

METHODS:

From our prospective stroke registry, we performed a retrospective study in all patients with the diagnosis of TIA admitted to the Stroke Unit of our Hospital between January 2008 and March 2018. NT-pro-BNP was determined in the first hours after TIA. The endpoint was the development of stroke during the follow-up.

RESULTS:

381 patients were included. Mean time of follow-up was 36.8 (±16.4) months. 224 patients were hospitalized due to a stroke during the follow-up, and 157 were not. NT-pro-BNP serum levels were higher in patients who suffered a stroke compared to those who did not (p ≪ 0.001). We also found greater levels of this marker the earlier the stroke happened (p = 0.024). A cut-off point of 800 pg/mL of NT-pro-BNP predicted a stroke with a sensitivity of 64% and a specificity of 79% (p ≪ 0.001), and was independently associated with higher risk of stroke after a TIA (OR: 6.65, p ≪ 0.001). This association persisted for different etiopathogenic TIA groups (cardioembolic: OR 26.12, p ≪ 0.001; undetermined: OR 4.87, p = 0.006; atherothrombotic: OR 1.67, p = 0.044).

CONCLUSIONS:

The early determination of NT-pro-BNP is a simple and very useful alternative to predict the prognosis after TIA regardless of the etiopathogenesis of the TIA.

• Authors: Emilio Rodríguez-Castro, Pablo Hervella, Iria López-Dequidt, Susana Arias-Rivas, María Santamaría-Cadavid, Ignacio López-Loureiro, Andrés da Silva-Candal, María Pérez-Mato, Tomás Sobrino, Francisco Campos, José Castillo, Manuel Rodríguez-Yáñez, Ramón Iglesias-Rey
• Journal: International journal of cardiology (Int J Cardiol) Vol. 298 Pg. 93-97 (01 01 2020) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 31272739 (Publication Type: Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier B.V.

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Female
• Follow-Up Studies
• Humans
• Ischemic Attack, Transient (blood, complications, diagnosis)
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prognosis
• Prospective Studies
• Retrospective Studies
• Risk Factors
• Stroke (blood, diagnosis, etiology)