title: Predictive value of plasma B-type natriuretic peptide for ischemic stroke: a community-based longitudinal study.
abstract: OBJECTIVE
  Structural heart diseases including atrial fibrillation are precursors for ischemic stroke. Plasma B-type natriuretic peptide (BNP) has been reported to be increased in patients with several types of structural heart diseases. However, the predictive value of plasma BNP for ischemic stroke remains unknown. We have studied the predictive ability of plasma BNP for future development of stroke in community dwelling adults.
  
  
  METHODS
  Subjects of this community-based study were recruited from the general population (n=13,466). Plasma BNP levels and cardiovascular risk factors were determined at baseline. The incidence of ischemic stroke in the cohort was identified from regional stroke registry data. A multivariate Cox regression analysis was performed to analyze the relationship between plasma BNP levels and the risk of stroke.
  
  
  RESULTS
  During a mean follow-up period of 2.8 years, 102 participants (65 males, 37 females) experienced a first ischemic stroke. In men, after adjustment for classical cardiovascular risk factors and atrial fibrillation, the hazard ratio (HR) for ischemic stroke was significantly elevated in the highest plasma BNP quartile (HR=2.38; 95% CI=1.07-5.29). In women, the relationship between plasma BNP levels and risk of ischemic stroke was of marginal significance after adjusting for the presence or absence of atrial fibrillation (HR=3.03; 95% CI=0.84-10.92, P=0.09).
  
  
  CONCLUSIONS
  Elevated plasma BNP levels predict the risk of ischemic stroke within men from the general population.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. ttomo@ruby.ocn.ne.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Takahashi
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Onoda
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Kozo
authors.initials: K
authors.lastname: Tanno
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Itai
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Sakata
authors.forename: Masafumi
authors.initials: M
authors.lastname: Sakuma
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Tanaka
authors.forename: Shinji
authors.initials: S
authors.lastname: Makita
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Akira
authors.initials: A
authors.lastname: Ogawa
authors.forename: Kazuko
authors.initials: K
authors.lastname: Kawamura
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
mesh_terms: D000368:Aged; D001685:Biological Factors / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015854:Up-Regulation
chemical_list: D001685:Biological Factors; D020097:Natriuretic Peptide, Brain