title: Plasma brain natriuretic Peptide as a predictive marker of early recurrent stroke in cardioembolic stroke patients.
abstract: BACKGROUND
  Whether brain natriuretic peptide (BNP) levels are associated with early recurrent stroke in cardioembolic stroke patients was investigated.
  
  
  METHODS
  From January 2010 to March 2014, consecutive patients within 24 hours of onset of cardioembolic stroke were prospectively enrolled, and admission plasma BNP levels were measured. Recurrent stroke was identified as the occurrence of additional neurologic deficits and the appearance of a new infarct on neuroimaging. Patients were divided into 2 groups: the recurrence group and the nonrecurrence group. Factors associated with stroke recurrence were investigated by multiple logistic regression analysis.
  
  
  RESULTS
  A total of 348 patients were included; 17 patients (5%) had recurrent stroke during hospitalization. The median interval from stroke onset to recurrent stroke was 4 days (range, 0-30). BNP levels were significantly higher in the recurrence group than in the nonrecurrence group (304.1 vs. 206.5 pg/mL, P = .029). The optimal cutoff level, sensitivity, and specificity of BNP levels to distinguish the recurrence group from the nonrecurrence group were 255.0 pg/mL, 76%, and 60%, respectively. On multivariate analysis after adjustment for confounders, plasma BNP ≥ 255.0 pg/mL (odds ratio, 5.21; 95% confidence interval, 1.63-16.72; P = .005) was independently associated with recurrent stroke during hospitalization in cardioembolic stroke patients.
  
  
  CONCLUSIONS
  Plasma BNP could be a useful marker for predicting early recurrent stroke during hospitalization in cardioembolic stroke patients.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan. Electronic address: shibaken@med.kawasaki-m.ac.jp.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Aoki
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Uemura
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D042241:Early Diagnosis; D004617:Embolism / Q000150:complications*; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: Brain natriuretic peptide; biochemical marker; cardioembolic stroke; early stroke recurrence