Plasma brain natriuretic peptide as a surrogate marker for cardioembolic stroke.
BACKGROUND
Cardioembolic stroke generally results in more severe disability, since it typically has a larger ischemic area than the other types of ischemic stroke. However, it is difficult to differentiate cardioembolic stroke from non-cardioembolic stroke (atherothrombotic stroke and lacunar stroke). In this study, we evaluated the levels of plasma brain natriuretic peptide in acute ischemic stroke patients with cardioembolic stroke or non-cardioembolic stroke, and assessed the prediction factors of plasma brain natriuretic peptide and whether we could differentiate between stroke subtypes on the basis of plasma brain natriuretic peptide concentrations in addition to patient's clinical variables.


METHODS
Our patient cohort consisted of 131 consecutive patients with acute cerebral infarction who were admitted to Kagawa University School of Medicine Hospital from January 1, 2005 to December 31, 2007. The mean age of patients (43 females, 88 males) was 69.6 +/- 10.1 years. Sixty-two patients had cardioembolic stroke; the remaining 69 patients had non-cardioembolic stroke (including atherothrombotic stroke, lacunar stroke, or the other). Clinical variables and the plasma brain natriuretic peptide were evaluated in all patients.


RESULTS
Plasma brain natriuretic peptide was linearly associated with atrial fibrillation, heart failure, chronic renal failure, and left atrial diameter, independently (F4,126 = 27.6, p < 0.0001; adjusted R2 = 0.45). Furthermore, atrial fibrillation, mitral regurgitation, plasma brain natriuretic peptide (> 77 pg/ml), and left atrial diameter (> 36 mm) were statistically significant independent predictors of cardioembolic stroke in the multivariable setting (Chi2 = 127.5, p < 0.001).


CONCLUSIONS
It was suggested that cardioembolic stroke was strongly predicted with atrial fibrillation and plasma brain natriuretic peptide. Plasma brain natriuretic peptide can be a surrogate marker for cardioembolic stroke.
Yukiiri
Kazushi
K
Department of Cardiorenal and Cerebrovascular Medicine, Division of Stroke, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kagawa 761-0793, Japan. kyukiiri@med.kagawa-u.ac.jp
Hosomi
Naohisa
N
Naya
Takayuki
T
Takahashi
Tsutomu
T
Ohkita
Hiroyuki
H
Mukai
Mao
M
Masugata
Hisashi
H
Murao
Koji
K
Ueno
Masaki
M
Nakamura
Takehiro
T
Dobashi
Hiroaki
H
Miki
Takanori
T
Kuroda
Yasuhiro
Y
Kohno
Masakazu
M
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications; D015415:Biomarkers / Q000097:blood*; D003328:Coronary Thrombosis / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D017700:Embolism, Cholesterol / Q000150:complications / Q000175:diagnosis; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009929:Organ Size; D011237:Predictive Value of Tests; D020521:Stroke / Q000175:diagnosis*
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain