title: Prognostic value of a single prehospital measurement of N-terminal pro-brain natriuretic peptide and troponin T after acute ischaemic stroke.
abstract: OBJECTIVE
  Data regarding the value of prehospital measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T as prognostic indicators of in-hospital mortality are limited. This prospective pilot study aimed to determine the value of a single combined measurement  of NT-proBNP and troponin T for predicting in-hospital mortality in patients with acute ischaemic stroke in a prehospital emergency medicine centre.
  
  
  METHODS
  Blood samples were collected in the prehospital setting and analysed for NT-proBNP and troponin T, using a portable device. Parameters  previously associated with stroke severity (including prognostic scoring systems) were recorded and assessed as independent predictors of in-hospital mortality.
  
  
  RESULTS
  In logistic regression analysis, elevated troponin T (odds ratio [OR] 1.8 [95% CI 1.1, 8.4) and elevated NT-proBNP (OR 5.80  [95% CI 1.3, 22.7]) were significantly associated with poor outcome in patients with acute ischaemic stroke. Combined measurement of troponin T plus NT-proBNP was most predictive of survival in stroke patients (93% sensitivity, 96% specificity, 80% negative predictive value, 98% positive predictive  value and 92% area under the receiver operating curve).
  
  
  CONCLUSIONS
  NT-proBNP and troponin T levels, measured during the prehospital phase of care after acute ischaemic stroke, are strong predictors of in-hospital mortality.
authors.affiliation: Centre for Emergency Medicine, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Ulica talcev 9, 2000 Maribor, Slovenia. ehajdi@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Hajdinjak
authors.forename: P
authors.initials: P
authors.lastname: Klemen
authors.forename: S
authors.initials: S
authors.lastname: Grmec
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D011379:Prognosis; D020521:Stroke / Q000097:blood / Q000401:mortality*; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain