title: Time course of NT-proBNP levels after acute ischemic stroke.
abstract: BACKGROUND
  Studies suggest that N-terminal-pro-brain natriuretic peptide (NT-proBNP) can be a biomarker of cardioembolic stroke. However, the best time to measure it after stroke is unknown. We studied the time course of NT-proBNP in patients with ischemic stroke.
  
  
  METHODS
  Consecutive acute ischemic stroke patients were admitted over 10 months to a Stroke Unit. Stroke type was classified according to TOAST. Blood samples were drawn within 24, 48, and 72 hours after stroke. Friedman test was used to compare NT-proBNP values across the 3 times in all, cardioembolic and non-cardioembolic stroke patients. Post hoc analysis with Wilcoxon signed-rank tests was conducted with a Bonferroni correction. Mann-Whitney test was used to compare median values of NT-proBNP between cardioembolic and non-cardioembolic stroke patients. ROC curves were drawn to determine NT-proBNP accuracy to diagnose cardioembolic stroke at 24, 48, and 72 hours after stroke onset.
  
  
  RESULTS
  One hundred and one patients were included (29 cardioembolic) with a mean age of 64.5±12.3 years. NT-proBNP values for cardioembolic stroke were significantly higher (P < 0.001) than for non-cardioembolic stroke in the 3 time points. NT-proBNP was highest in the first 24-48 h after ischemic stroke and decreased significantly 72 h after stroke onset. The area under the curve for the three time points was similar.
  
  
  CONCLUSIONS
  NT-proBNP levels were highest in the first 2 days after ischemic stroke and declined significantly thereafter. However, the area under the curve for the three time points was similar. The first 72 hours after ischemic stroke have a similar diagnostic accuracy to diagnose cardioembolic stroke.
authors: Department of Neurosciences (Neurology), Hospital de Santa Maria, Lisboa, Portugal.
authors: A C
authors: AC
authors: Fonseca
authors: J S
authors: JS
authors: Matias
authors: T P
authors: TP
authors: E Melo
authors: C
authors: C
authors: Pires
authors: R
authors: R
authors: Geraldes
authors: P
authors: P
authors: Canhão
authors: D
authors: D
authors: Brito
authors: J M
authors: JM
authors: Ferro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D019370:Observation; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D011859:Radiography; D018709:Statistics, Nonparametric; D020521:Stroke / Q000097:blood* / Q000209:etiology / Q000473:pathology; D013997:Time Factors; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: NT-ProBNP; biomarker; cardioembolism; etiology; stroke; time course