title: Brain natriuretic peptide predicts functional outcome in ischemic stroke.
abstract: OBJECTIVE
  Elevated serum levels of brain natriuretic peptide (BNP) have been associated with cardioembolic stroke and increased poststroke mortality. We sought to determine whether BNP levels were associated with functional outcome after ischemic stroke.
  
  
  METHODS
  We measured BNP in consecutive patients aged ≥ 18 years admitted to our stroke unit between 2002 to 2005. BNP quintiles were used for analysis. Stroke subtypes were assigned using Trial of ORG 10172 in Acute Stroke Treatment criteria. Outcomes were measured as 6-month modified Rankin Scale score ("good outcome"=0-2 versus "poor") as well as mortality. Multivariate logistic regression was used to assess association between the quintiles of BNP and outcomes. Predictive performance of BNP as compared with clinical model alone was assessed by comparing receiver operating characteristic curves.
  
  
  RESULTS
  Of 569 patients with ischemic stroke, 46% were female; mean age was 67.9 ± 15 years. In age- and gender-adjusted analysis, elevated BNP was associated with lower ejection fraction (P<0.0001) and left atrial dilatation (P<0.001). In multivariate analysis, elevated BNP decreased the odds of good functional outcome (OR, 0.64; 95% CI, 0.41-0.98) and increased the odds of death (OR, 1.75; 95% CI, 1.36-2.24) in these patients. Addition of BNP to multivariate models increased their predictive performance for functional outcome (P=0.013) and mortality (P<0.03) after cardioembolic stroke.
  
  
  CONCLUSIONS
  Serum BNP levels are strongly associated with cardioembolic stroke and functional outcome at 6 months after ischemic stroke. Inclusion of BNP improved prediction of mortality in patients with cardioembolic stroke.
authors: J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, 175 Cambridge Street, Suite 300, Boston, MA 02114, USA. nrost@partners.org
authors: Natalia S
authors: NS
authors: Rost
authors: Alessandro
authors: A
authors: Biffi
authors: Lisa
authors: L
authors: Cloonan
authors: John
authors: J
authors: Chorba
authors: Peter
authors: P
authors: Kelly
authors: David
authors: D
authors: Greer
authors: Patrick
authors: P
authors: Ellinor
authors: Karen L
authors: KL
authors: Furie
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D020521:Stroke / Q000097:blood* / Q000150:complications / Q000401:mortality; D013318:Stroke Volume / Q000502:physiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D020097:Natriuretic Peptide, Brain