title: Prognostic value of plasma neuroendocrine biomarkers in patients with acute ischaemic stroke.
abstract: Inflammation and activation of the neuroendocrine systems comprise important aspects of stroke pathophysiology. The present study investigated whether baseline plasma brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP), cortisol and copeptin levels on admission can predict short-term outcomes and mortality after acute ischaemic stroke. The study group consisted of 189 patients who had their first acute ischaemic stroke. Plasma levels of BNP, NT-proBNP, cortisol and copeptin were evaluated to determine their value with respect to predicting functional outcome and mortality within 3 months. As a result of cardiovascular and neurological investigations (including imaging techniques), lesion size, stroke subtype classification and clinical outcome after 3 months were determined. Plasma levels of BNP, NT-proBNP, cortisol and copeptin were associated with stroke severity, as well as short-term functional outcomes. After adjusting for all other significant outcome predictors, NT-proBNP, cortisol and copeptin remained as independent outcome predictors. In the receiver operating characteristic curve analysis, the biomarker panel (including BNP, NT-proBNP, cortisol and copeptin) predicted functional outcome and death within 90 days significantly more efficiently than the National Institute of Health Stroke Scale (NIHSS) or the biomarker alone. Copeptin showed a significantly greater discriminatory ability as a single biomarker compared to BNP, NT-proBNP, cortisol and NIHSS score. These results suggest that a biomarker panel may add valuable and time-sensitive prognostic information in the early evaluation of acute ischaemic stroke. This may provide a channel for interventional therapy in acute stroke.
authors.affiliation: China Rehabilitation Research Center and School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
authors.forename: W-J
authors.initials: WJ
authors.lastname: Tu
authors.forename: X
authors.initials: X
authors.lastname: Dong
authors.forename: S-J
authors.initials: SJ
authors.lastname: Zhao
authors.forename: D-G
authors.initials: DG
authors.lastname: Yang
authors.forename: H
authors.initials: H
authors.lastname: Chen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D059906:Neuroimaging; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; D010446:Peptide Fragments; C048197:copeptins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D006854:Hydrocortisone
keywords: acute ischaemic stroke; biomarker; neuroendocrine; prognostic