Predictive value of plasma B-type natriuretic peptide for ischemic stroke: a community-based longitudinal study.
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.
Takahashi
Tomohiro
T
Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. ttomo@ruby.ocn.ne.jp
Nakamura
Motoyuki
M
Onoda
Toshiyuki
T
Ohsawa
Masaki
M
Tanno
Kozo
K
Itai
Kazuyoshi
K
Sakata
Kiyomi
K
Sakuma
Masafumi
M
Tanaka
Fumitaka
F
Makita
Shinji
S
Yoshida
Yuki
Y
Ogawa
Akira
A
Kawamura
Kazuko
K
Okayama
Akira
A
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
D001685:Biological Factors; D020097:Natriuretic Peptide, Brain