Association between N-terminal pro-brain natriuretic peptide and acute ischemic stroke in patients on chronic hemodialysis.
BACKGROUND
Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) has been reported as a predictor for ischemic stroke in general population. However, predictive value of plasma NT-proBNP for acute ischemic stroke in patients on chronic hemodialysis has not been well established. The aim of this study was to determine whether NT-proBNP could predict acute ischemic stroke in patients on chronic hemodialysis.


METHODS
This study was designed prospectively. Clinical, laboratory, and echocardiographic variables were assessed in 72 patients on chronic hemodialysis. The plasma levels of NT-proBNP were measured by immunoassay.


RESULTS
During the follow-up period of 45 months, 11 patients had an acute ischemic stroke. The Kaplan-Meier plot showed an increased frequency of acute ischemic stroke in patients with plasma levels of NT-proBNP above the median values compared to patients with lower concentrations (P = 0.028). The multivariate Cox proportional hazard models showed that the NT-proBNP was a significant independent predictor of acute ischemic stroke after adjustment for age, sex, mean blood pressure, diabetes, serum cholesterol levels, left ventricular mass index, and left ventricular fractional shortening (HR 6.66, 95% CI, 1.22-36.48, P = 0.029).


CONCLUSIONS
Our data suggest that plasma NT-proBNP levels predict the risk of acute ischemic stroke in patients on chronic hemodialysis.
Kim
Yong Kyun
YK
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Shin
Seok Joon
SJ
Ihm
Sang-Hyun
SH
Park
Chan Seok
CS
Kim
Hee-Yeol
HY
Kim
Young-Du
YD
Shim
Dong Suk
DS
Song
Ho Cheol
HC
Yang
Chul Woo
CW
Kim
Yong-Soo
YS
Choi
Euy Jin
EJ
D000208:Acute Disease; D002545:Brain Ischemia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain