Brain natriuretic peptide on admission as a biological marker of long-term mortality in ischemic stroke survivors

Kensaku Shibazaki, Kazumi Kimura, Kenichiro Sakai, Shuichi Fujii, Junya Aoki, Naoki Saji
European Neurology 2013, 70 (3): 218-24

BACKGROUND AND PURPOSE: We investigated whether brain natriuretic peptide (BNP) can serve as a biological marker of long-term mortality in ischemic stroke survivors.

METHODS: Consecutive patients with ischemic stroke within 24 h of onset from April 2007 to December 2010 were prospectively enrolled, and admission plasma BNP levels were measured. Survivors were followed up until 1 year after stroke onset. Patients were divided into two groups: the deceased group and the surviving group. The factors associated with long-term mortality were investigated by multiple logistic regression analysis.

RESULTS: A total of 736 patients who were alive at hospital discharge were included; 130 (17.7%) patients died. On multivariate analysis, age>75 years (odds ratio, OR, 2.83; 95% CI, 1.74-4.60, p=0.0001), dialysis-dependent chronic renal failure (OR, 5.99; 95% CI, 2.18-16.47, p=0.0005), modified Rankin Scale score>3 at discharge (OR, 4.41; 95% CI, 2.76-7.05, p<0.0001), and plasma BNP>100.0 pg/ml (OR, 3.94; 95% CI, 2.31-6.73, p<0.0001) were found to be independently associated with long-term mortality. We developed a risk score from 4 variables (each variable: 1 point, total score: 0-4 points). The mortality rates were 2% with a score of 0, 9% with a score of 1, 27% with a score of 2 and 50% with a score≥3.

CONCLUSIONS: The risk score, composed of clinical parameters and BNP, may predict long-term mortality in ischemic stroke survivors.

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