Emilio Rodríguez-Castro1, Pablo Hervella2, Iria López-Dequidt3, Susana Arias-Rivas3, María Santamaría-Cadavid3, Ignacio López-Loureiro2, Andrés da Silva-Candal2, María Pérez-Mato2, Tomás Sobrino2, Francisco Campos2, José Castillo2, Manuel Rodríguez-Yáñez3, Ramón Iglesias-Rey4. 1. Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain; Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. Electronic address: emiliorcastro@gmail.com. 2. Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. 3. Stroke Unit, Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain; Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. 4. Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain. Electronic address: ramon.iglesias.rey@sergas.es.
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.
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: Pablo Hervella; María Luz Alonso-Alonso; María Pérez-Mato; Manuel Rodríguez-Yáñez; Susana Arias-Rivas; Iria López-Dequidt; José M Pumar; Tomás Sobrino; Francisco Campos; José Castillo; Ramón Iglesias-Rey Journal: BMC Neurol Date: 2022-06-09 Impact factor: 2.903