Conflict of interest: The authors declare no potential conflict of interest.
Aortic stiffness and plasma brain natriuretic peptide predicts mortality in acute ischemic stroke
Article first published online: 22 MAY 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Volume 10, Issue 5, pages 679–685, July 2015
How to Cite
Biteker, M., Özden, T., Dayan, A., Tekkeşin, A. İ. and Mısırlı, C. H. (2015), Aortic stiffness and plasma brain natriuretic peptide predicts mortality in acute ischemic stroke. International Journal of Stroke, 10: 679–685. doi: 10.1111/ijs.12049
- Issue published online: 16 JUN 2015
- Article first published online: 22 MAY 2013
- Manuscript Accepted: 29 OCT 2012
- Manuscript Received: 2 MAY 2012
- acute ischemic stroke;
- aortic stiffness;
- brain natriuretic peptide;
- transthoracic echocardiography
The study aimed to evaluate the prognostic role and discriminative power of aortic stiffness and plasma brain natriuretic peptide levels in a cohort of patients hospitalized for acute ischemic stroke.
Methods and Results
Three hundred and ten consecutive patients aged 50 years and older with a first episode of acute ischemic stroke were prospectively evaluated. All patients were admitted to the hospital within 24 h of the onset of stroke symptoms. The type of acute ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment classification. Blood samples were taken for measurement of brain natriuretic peptide levels at admission. Aortic stiffness indices, aortic strain and distensibility, were calculated from the aortic diameters measured by transthoracic echocardiography. The patients were followed for one-year or until death, whichever came first. Death occurred in 51 (16·5%) patients. On multivariate logistic regression analysis, National Institutes of Health Stroke Scale score >13, diabetes, brain natriuretic peptide >235 pg/mL, aortic distensibility, and aortic strain were associated with all-cause mortality. The optimal cutoff level of brain natriuretic peptide to distinguish the deceased group from the survival group was 235 pg/mL (sensitivity 71·0% and specificity 63·0%) and to distinguish cardioembolic stroke from noncardioembolic stroke was 155 pg/mL (sensitivity 81% and specificity 63%).
Aortic stiffness and brain natriuretic peptide predict mortality in patients with first-ever acute ischemic stroke. Brain natriuretic peptide also differentiates cardioembolic stroke from noncardioembolic stroke.