Abstract T P152: N-terminal Pro-brain Natriuretic Peptide Predicts Short-term Functional Outcome In Acute Ischemic Stroke
Introduction: N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts poor outcome in cardiovascular disease. The prognostic value of NT-proBNP in acute ischemic stroke is limited and remains controversial. We sought to determine whether NT-proBNP at admission were associated with short-term functional outcome after acute ischemic stroke. Methods: We measured fasting serum NT-proBNP in consecutive 357 patients (62.2% men, mean age 65.8±13.0 years) within 3 days after the onset of acute ischemic stroke. Outcomes were measured as 3-month modified Rankin Scale (mRS) score. A good functional outcome was defined as a mRS of 0-2 points, whereas a poor outcome was defined as a mRS of >2 points. Multivariate logistic regression was used to assess association between the clinical and serological parameters including NT-proBNP and mRS scores. Results: The frequency of atrial fibrillation, heart failure, hypertension, and diabetes, the NIHSS score at admission, and the level of NT-proBNP, hs-CRP, creatine kinase-MB and D-dimer were each significantly higher in the poor outcome group (p <0.05). The cut-off values of NT-proBNP level and NIHSS score on admission for prediction of the poor outcome were 183 pg/ml (sensitivity 0.758, specificity 0.756) and 3.5 (sensitivity 0.862, specificity 0.787), respectively. In age- and serum creatinine-adjusted analysis, plasma NT-proBNP levels were significantly correlated with CHADS2 scores (partial r = 0.446, p = 0.009) and CHA2DS2-VASc scores (partial r = 0.347, p = 0.048) in stroke with atrial fibrillation and ejection fraction (partial r = -0.358, p = 0.041) and interventricular septal end diastolic dimension (partial r = 0.371, p = 0.033) on echocardiogram. Multivariate logistic regression analysis demonstrated that age of ≥65 (OR, 7.0; 95% CI, 2.48-19.83, p<0.001), presence of diabetes mellitus (OR, 2.5; 95% CI, 1.09-5.78, p = 0.03), NIHSS score of ≥7 (OR, 18.9 95% CI, 7.84-45.46, p<0.001), NT-proBNP of ≥183 pg/ml (OR, 3.0; 95% CI, 1.20-7.39, p = 0.019) were independently associated with poor functional outcome. Conclusion: Serum NT-proBNP is a useful marker for short-term outcome in acute ischemic stroke. NT-ProBNP may have a role in risk stratification for predicting poor outcome.
Author Disclosures: J. Lee: None. K. Kim: None. B. Jeon: None. M. Kim: None. B. Yoo: None.
- © 2015 by American Heart Association, Inc.