title: N-terminal pro-B-type natriuretic peptide and the risk of stroke and transient ischaemic attack: the Rotterdam Study.
abstract: OBJECTIVE
  Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is a predictor of heart disease. It has also been related to stroke, but its association with transient ischaemic attacks (TIAs) is unclear. Moreover, it is unknown how clinical heart disease influences this relation. Within the prospective population-based Rotterdam Study, the association of NT-proBNP with stroke and TIA was examined and the role of heart disease on this association was investigated.
  
  
  METHODS
  NT-proBNP was measured in 1997-2001 in 5611 participants (mean age 68.7 years; 57.7% women) without a history of stroke, TIA or heart failure. Follow-up for stroke and TIA finished in 2012. Models were adjusted for age and cardiovascular risk factors, and were stratified by sex.
  
  
  RESULTS
  During 22 058 person-years 195 men suffered a stroke and 118 a TIA. During 31 825 person-years 230 women suffered a stroke and 187 a TIA. Higher NT-proBNP was associated with a higher risk of stroke in men [hazard ratio (HR) per SD increase 1.50; 95% confidence interval (CI) 1.29-1.76] and in women (HR 1.24; 95% CI 1.05-1.46). Associations with TIA were only present in women (HR 1.51; 95% CI 1.26-1.82) but not in men (HR 1.02; 95% CI 0.83-1.26). Excluding persons with a history of clinical coronary heart disease, heart failure or atrial fibrillation and censoring for clinical heart disease during follow-up did not change the associations.
  
  
  CONCLUSIONS
  Higher NT-proBNP is associated with incident stroke in men and women and with incident TIA only in women. These associations are independent of clinical heart disease preceding cerebrovascular disease.
authors.affiliation: Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: M L P
authors.initials: ML
authors.lastname: Portegies
authors.forename: M
authors.initials: M
authors.lastname: Kavousi
authors.forename: M J G
authors.initials: MJ
authors.lastname: Leening
authors.forename: M J
authors.initials: MJ
authors.lastname: Bos
authors.forename: A H
authors.initials: AH
authors.lastname: van den Meiracker
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: O H
authors.initials: OH
authors.lastname: Franco
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: M A
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009426:Netherlands / Q000453:epidemiology; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000453:epidemiology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: NT-proBNP; epidemiology; risk factors; stroke; transient ischaemic attack