Plasma brain natriuretic peptide predicts death during hospitalization in acute ischaemic stroke and transient ischaemic attack patients with atrial fibrillation
Version of Record online: 26 MAY 2010
© 2010 The Author(s). European Journal of Neurology © 2010 EFNS
European Journal of Neurology
Volume 18, Issue 1, pages 165–169, January 2011
How to Cite
Shibazaki, K., Kimura, K., Iguchi, Y., Aoki, J., Sakai, K. and Kobayashi, K. (2011), Plasma brain natriuretic peptide predicts death during hospitalization in acute ischaemic stroke and transient ischaemic attack patients with atrial fibrillation. European Journal of Neurology, 18: 165–169. doi: 10.1111/j.1468-1331.2010.03101.x
- Issue online: 15 DEC 2010
- Version of Record online: 26 MAY 2010
- Received 22 November 2009 Accepted 12 April 2010
- atrial fibrillation;
- brain natriuretic peptide;
- in-hospital mortality;
- ischaemic stroke;
- transient ischaemic attack
Background and purpose: Atrial fibrillation (AF) is the most powerful predictor of early death in patients with acute ischaemic stroke. We investigated whether the plasma brain natriuretic peptide (BNP) level on admission can serve as a biological marker of in-hospital death in acute ischaemic stroke and transient ischaemic attack (TIA) patients with AF.
Methods: We prospectively enrolled ischaemic stroke and TIA patients with AF within 24 h of onset and measured plasma BNP on admission. Patients were divided into two groups: the deceased group, who died during hospitalization, and the survival group. The factors associated with in-hospital death were investigated by multivariate logistic regression analysis.
Results: A total of 221 patients with AF were enrolled. Death occurred in 24 (10.9%) patients. The mean ± SD of the plasma BNP level of the deceased group was significantly higher than that of the survival group (714.1 ± 716.3 vs. 320.0 ± 380.7 pg/ml, P < 0.0001). The optimal cutoff level, sensitivity, and specificity of BNP levels to distinguish the deceased group from the survival group were 320 pg/ml, 79.2, and 69.0%, respectively. Multivariate logistic regression analysis demonstrated that age per 10 years increase (OR, 3.56; 95% CI, 1.728–7.346, P = 0.0006), internal carotid artery occlusion (OR, 10.20; 95% CI, 2.525–41.177, P = 0.0011), NIHSS score of >17 (OR, 4.68; 95% CI, 1.137–19.286, P = 0.0325), and plasma BNP level of >320 pg/ml (OR, 4.74; 95% CI, 1.260–17.800, P = 0.0213) were independent factors associated with in-hospital death.
Conclusion: The plasma BNP level on admission can predict in-hospital death in acute ischaemic stroke and TIA patients with AF.