title: Aortic stiffness and plasma brain natriuretic peptide predicts mortality in acute ischemic stroke.
abstract: BACKGROUND
  The study aimed to evaluate the prognostic role and discriminative power of aortic stiffness and plasma brain natriuretic peptide levels in a cohort of patients hospitalized for acute ischemic stroke.
  
  
  RESULTS
  Three hundred and ten consecutive patients aged 50 years and older with a first episode of acute ischemic stroke were prospectively evaluated. All patients were admitted to the hospital within 24 h of the onset of stroke symptoms. The type of acute ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment classification. Blood samples were taken for measurement of brain natriuretic peptide levels at admission. Aortic stiffness indices, aortic strain and distensibility, were calculated from the aortic diameters measured by transthoracic echocardiography. The patients were followed for one-year or until death, whichever came first. Death occurred in 51 (16·5%) patients. On multivariate logistic regression analysis, National Institutes of Health Stroke Scale score >13, diabetes, brain natriuretic peptide >235 pg/mL, aortic distensibility, and aortic strain were associated with all-cause mortality. The optimal cutoff level of brain natriuretic peptide to distinguish the deceased group from the survival group was 235 pg/mL (sensitivity 71·0% and specificity 63·0%) and to distinguish cardioembolic stroke from noncardioembolic stroke was 155 pg/mL (sensitivity 81% and specificity 63%).
  
  
  CONCLUSIONS
  Aortic stiffness and brain natriuretic peptide predict mortality in patients with first-ever acute ischemic stroke. Brain natriuretic peptide also differentiates cardioembolic stroke from noncardioembolic stroke.
authors.affiliation: Department of Cardiology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Biteker
authors.affiliation: Department of 1st Neurology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Temel
authors.initials: T
authors.lastname: Özden
authors.affiliation: Department of Family Medicine, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Akın
authors.initials: A
authors.lastname: Dayan
authors.affiliation: Department of Cardiology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet İlker
authors.initials: Aİ
authors.lastname: Tekkeşin
authors.affiliation: Department of 1st Neurology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Cemile Handan
authors.initials: CH
authors.lastname: Mısırlı
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D004452:Echocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000401:mortality / Q000503:physiopathology; D059289:Vascular Stiffness
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: acute ischemic stroke; aortic stiffness; brain natriuretic peptide; transthoracic echocardiography