Prognostic Value of NT-proBNP and Left Atrial Diameter for AtrialFibrillation in the Chronic Phase of Cryptogenic Stroke

Introduction: This study investigated whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and left atrial diameter (LAD) serve as reliable prognostic markers for the development of previously undetermined atrial fibrillation (AF) in patients with cryptogenic stroke (CS). The primary objective was to evaluate the association of these markers with AF during long-term follow-up to improve risk prediction. Methods: A retrospective observational cohort design was used to evaluate CS patients treated between 2022 and 2024. Seventy-one individuals with available serum NT-proBNP values and transthoracic echocardiography-derived LAD measurements taken six months after stroke onset were included. The study population consisted of 42 men and 29 women, with a mean age of 67.92 ± 11.49 years. AF was identified in 31 patients during follow-up. Methods: A retrospective observational cohort design was used to evaluate CS patients treated between 2022 and 2024. Seventy-one individuals with available serum NT-proBNP values and transthoracic echocardiography-derived LAD measurements taken six months after stroke onset were included. The study population consisted of 42 men and 29 women, with a mean age of 67.92 ± 11.49 years. AF was identified in 31 patients during follow-up. Results: Patients who developed AF were significantly older than those without AF (p < 0.001), and the proportion of women was higher in the AF group (p = 0.003). Coronary artery disease occurred more frequently among AF patients (p = 0.017), whereas smoking was reported more often in individuals without AF (p = 0.037). The AF group also demonstrated higher baseline NIHSS scores and greater LAD (p < 0.05). NT-proBNP concentrations were notably elevated in patients who developed AF (p = 0.001). Discussion: Elevated NT-proBNP and increased LAD are significant indicators of atrial remodeling and hemodynamic stress in CS. These markers effectively identify high-risk patients who require intensive cardiac investigation to detect underlying atrial fibrillation. Conclusion: In conclusion, NT-proBNP and LAD serve as reliable prognostic predictors of AF in the chronic phase of CS. Integrating these biomarkers into clinical evaluation is essential for optimizing secondary stroke prevention through timely anticoagulation