The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide.
Anaemia is a negative prognostic factor for patients with heart failure and impaired renal function, but its role in stroke patients is unknown. Furthermore, anaemia has been shown to influence the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), but this is only investigated in patients with heart failure, not in stroke patients. Two-hundred-and-fifty consecutive, well-defined ischemic stroke patients were investigated. Mortality was recorded at 6 months follow-up. Anaemia was diagnosed in 37 patients (15%) in whom stroke severity was worse than in the non-anaemic group, whilst the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using logistic regression. The median NT-proBNP level in the anaemic group was significantly higher than in the non-anaemic group, and in a multivariate linear regression model, anaemia remained an independent predictor of NT-proBNP. Conclusively, anaemia was found to be a negative prognostic factor for ischemic stroke patients. Furthermore, anaemia influenced the NT-proBNP level in ischemic stroke patients, an important aspect when interpreting NT-proBNP in these patients.
Nybo
M
M
Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. mads.nybo@rh.hosp.dk
Kristensen
S R
SR
Mickley
H
H
Jensen
J K
JK
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D002545:Brain Ischemia / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology; D015984:Causality; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012039:Regional Blood Flow / Q000502:physiology; D051437:Renal Insufficiency / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D013312:Stress, Physiological / Q000378:metabolism / Q000503:physiopathology; D020521:Stroke / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain