title: Plasma Brain Natriuretic Peptide is a Marker of Prognostic Functional Outcome in Non-Cardioembolic Infarction.
abstract: BACKGROUND
  High plasma levels of brain natriuretic peptide (BNP) may also be observed in patients with non-cardioembolic infarction (CEI). We aimed to evaluate the relation between plasma BNP level, clinical parameters, and functional outcome in patients with and without CEI.
  
  
  METHODS
  This study analyzed consecutive Japanese patients with acute ischemic stroke. Correlations between plasma BNP level and conventional risk factors for ischemic stroke were examined. Values of P less than .05 were considered statistically significant.
  
  
  RESULTS
  This study analyzed 718 acute ischemic stroke patients (445 men and 273 women; mean age, 73.9 years). Mean plasma level of BNP was significantly higher for CEI (366.6 pg/ml) than for non-CEI (105.6 pg/ml; P < .01). Poor outcome (modified Rankin Scale score ≥3) at hospitalization and discharge were associated with significantly higher plasma BNP level than good outcome (modified Rankin Scale score ≤2) for both CEI and non-CEI. On multiple regression analysis, log-BNP was significantly associated with female sex, smoking, triglyceride, and creatinine clearance in CEI. In non-CEI, log-BNP was significantly associated with systolic/diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol, and creatinine clearance.
  
  
  CONCLUSIONS
  Irrespective of the presence of CEI, plasma BNP offers a marker of prognostic functional outcome. We clarified the characteristics and differences associated with plasma BNP in CEI and non-CEI, and our results suggest that plasma BNP can provide a useful marker of brain damage and neurohumoral dynamics in acute ischemic stroke.
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan. Electronic address: charley.sk@med.tottori-u.ac.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kawase
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Kowa
authors.affiliation: Department of Neurology, Tottori Prefectural Central Hospital, Tottori, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suto
authors.affiliation: Department of Neurology, Matsue Red Cross Hospital, Matsue, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Department of Neurology, Sanin Rosai Hospital, Yonago, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kusumi
authors.affiliation: Department of Neurology, Tottori Prefectural Central Hospital, Tottori, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakayasu
authors.affiliation: Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D059409:Stroke, Lacunar / Q000209:etiology
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: brain damage; modified Rankin Scale; neurohumoral change; renin-angiotensin aldosterone system; sympathetic nervous system