The relation between electrocardiographic ST-T changes and NT-proBNP in patients with acute ischemic stroke.
BACKGROUND
ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram (ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides in patients with an acute ischemic stroke exists.


METHODS
Serial measurements of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 12-lead ECGs were obtained in 192 consecutive patients with an acute ischemic stroke without ischemic heart disease, atrial fibrillation, heart- or renal failure.


RESULTS
ST-T changes suggestive of myocardial ischemia were observed in the 12 lead ECG of 47 patients (24%). In uni- and multivariate regression analysis after adjustment for age, stroke severity, female sex, systolic blood pressure, diabetes mellitus, and levels of troponin T > 0.03 microg/L, ST-T changes in the ECG remained associated with increased levels of NT-proBNP (beta=76.5, p=0.011).


CONCLUSIONS
ST-T changes suggestive of myocardial ischemia are independently associated with the levels of NT-proBNP in patients with acute ischemic stroke. The clinical importance of this observation remains to be defined.
Jensen
Jesper K
JK
Department of Cardiology, Odense University Hospital, Denmark. jesperkjensen@dadlnet.dk
Korsholm
Lars
L
Høilund-Carlsen
Poul Flemming
PF
Atar
Dan
D
Kristensen
Søren R
SR
Mickley
Hans
H
D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain