title: Brain natriuretic peptide on admission as a biological marker of long-term mortality in ischemic stroke survivors.
abstract: OBJECTIVE
  We investigated whether brain natriuretic peptide (BNP) can serve as a biological marker of long-term mortality in ischemic stroke survivors.
  
  
  METHODS
  Consecutive patients with ischemic stroke within 24 h of onset from April 2007 to December 2010 were prospectively enrolled, and admission plasma BNP levels were measured. Survivors were followed up until 1 year after stroke onset. Patients were divided into two groups: the deceased group and the surviving group. The factors associated with long-term mortality were investigated by multiple logistic regression analysis.
  
  
  RESULTS
  A total of 736 patients who were alive at hospital discharge were included; 130 (17.7%) patients died. On multivariate analysis, age>75 years (odds ratio, OR, 2.83; 95% CI, 1.74-4.60, p=0.0001), dialysis-dependent chronic renal failure (OR, 5.99; 95% CI, 2.18-16.47, p=0.0005), modified Rankin Scale score>3 at discharge (OR, 4.41; 95% CI, 2.76-7.05, p<0.0001), and plasma BNP>100.0 pg/ml (OR, 3.94; 95% CI, 2.31-6.73, p<0.0001) were found to be independently associated with long-term mortality. We developed a risk score from 4 variables (each variable: 1 point, total score: 0-4 points). The mortality rates were 2% with a score of 0, 9% with a score of 1, 27% with a score of 2 and 50% with a score≥3.
  
  
  CONCLUSIONS
  The risk score, composed of clinical parameters and BNP, may predict long-term mortality in ischemic stroke survivors.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sakai
authors.forename: Shuichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Junya
authors.initials: J
authors.lastname: Aoki
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010343:Patient Admission; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood* / Q000401:mortality*; D017741:Survivors
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain