Key result
Greater NT-proBNP and hsCRP serum concentrations were independently associated with greater clinical stroke severity (p=0.012 and p=0.009, respectively) in acute stroke patients.
Why the study?
Do NT-proBNP, hsCRP, and IL-6 concentrations predict stroke severity and functional/cognitive outcomes at discharge in acute stroke patients?
Observational (n=78)
Do NT-proBNP, hsCRP, and IL-6 concentrations predict stroke severity and functional/cognitive outcomes at discharge in acute stroke patients?
Effect estimate: β = -0.292
p-value: p=0.012
Elevated NT-proBNP, hsCRP, and IL-6 in acute stroke patients are independently associated with greater stroke severity and worse functional and cognitive outcomes at discharge.
Should not yet alter acute stroke management; hypothesis-generating for biomarker integration into severity models.
OBJECTIVE: N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6) concentrations can be important biomarkers in the acute stroke setting. In acute ischemic and hemorrhagic stroke patients, we investigated the association of NT-proBNP, hsCRP, and IL-6 serum concentrations with stroke severity and functional and cognitive outcomes at discharge. METHODS: Seventy-eight patients (53 men; median age 72 years) admitted with ischemic or hemorrhagic stroke within 48 h of symptom onset were evaluated for clinical stroke severity (Scandinavian stroke scale; SSS), functional status before the stroke (modified Rankin scale; mRS), and cerebrovascular disease risk factors. Cognitive (Mini Mental State Examination) and functional (mRS) outcomes were evaluated at hospital discharge. Blood samples were drawn for the assessment of NT-proBNP, hsCRP, and IL-6 concentrations within 24 h of admission. RESULTS: Greater NT-proBNP and hsCRP serum concentrations were associated with greater clinical stroke severity, adjusting for the patients' gender, age, stroke type, mRS score on admission, and presence of heart failure (β = -0.292, p = 0.012; β = -0.303, p = 0.009). In multivariate adjusted regression models with IL-6, hsCRP, and NT-proBNP considered together, IL-6 and hsCRP remained associated with worse functional (β = 0.210, p = 0.022) and cognitive (β = -0.269, p = 0.014) outcomes at discharge, respectively. In receiver operating characteristic analyses, the investigated blood biomarkers produced a minimal increase in predictive values for outcomes at discharge above the SSS score, age, and gender. CONCLUSIONS: In acute stroke patients, greater NT-proBNP and hsCRP serum concentrations are independently associated with greater clinical stroke severity. Elevated concentrations of IL-6 and hsCRP are associated with worse functional and cognitive outcomes at discharge, respectively.
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Bunevičius et al. (2015) conducted an observational in Acute ischemic and hemorrhagic stroke (n=78). NT-proBNP, hsCRP, and IL-6 serum concentrations was evaluated on Clinical stroke severity (Scandinavian stroke scale) (β = -0.292, p=0.012). Greater NT-proBNP and hsCRP serum concentrations were independently associated with greater clinical stroke severity (p=0.012 and p=0.009, respectively) in acute stroke patients.
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