N-terminal pro-B-type natriuretic peptide predicts long-term mortality but not stroke recurrence in acute ischemic stroke patients with a cardioembolic source (P1.051)

OBJECTIVE: To investigate the relationship of N-terminal pro-BNP (NT-proBNP) with each cardioembolic source, functional outcome, short-/long-term mortality, and stroke recurrence in stroke patients with cardioembolic mechanism. BACKGROUND: There is little information on the relationship of B-type natriuretic peptide (BNP) with each cardioembolic source, long-term mortality, and stroke recurrence in the literature. DESIGN/METHODS: A total of 221 acute stroke patients with a cardioembolic source were included in this study. The study patients were classified into high or low BNP group based on the median value of NT-proBNP (蠅 or < 1018 pg/ml). Logistic regression analysis was performed to clarify the variables significantly related to the 6-month functional outcome and mortality. Cox proportional hazards model was used to determine the association between NT-proBNP and long-term mortality. P-values < 0.05 were considered statistically significant. RESULTS: Median follow-up period was 20.5 months (range, 0.1 - 40.2 months). On the univariate logistic regression analysis, the good functional outcome (modified Rankin scale ≤ 2) at 6 months was negatively associated with advanced age, female gender, azotemia, left ventricular systolic dysfunction, NT-proBNP, and National Institutes of Health Stroke Scale (NIHSS). However, NIHSS alone remained a significant predictor of functional outcome on the multivariate analysis using the variables with P <0.1. Compared with the low BNP group, the high BNP group had a higher mortality (P < 0.001 by log rank test), whereas there was no significant difference in stroke recurrence between the two groups (P = 0.350 by log rank test). The multivariate Cox proportional hazards regression analysis showed that NT-proBNP, together with azotemia and NIHSS at admission, was a significant predictor of long-term mortality. CONCLUSIONS: Our study showed that the plasma level of NT-proBNP significantly predicted short-and long-term mortality although it was not associated with stroke recurrence in stroke patients with a cardioembolic source.