Abstract WP206: Brain Natriuretic Peptide Should Be A Predictive Marker Of Long-term Mortality In Ischemic Stroke Survivors

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Shuichi Fujii ◽  
Kenichiro Sakai ◽  
Jyunya Aoki
Keyword(s):  
Ischemic Stroke ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Multiple Logistic Regression Analysis ◽  
Biological Marker ◽  
Predictive Marker ◽  
Stroke Survivors ◽  
Survival Group ◽  
Long Term Mortality

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 We prospectively enrolled consecutive patients with ischemic stroke within 24 hours of onset from April 2007 to December 2010 and measured plasma BNP upon admission. Survivors were followed up to 12 month after stroke onset. Patients were divided into two groups: the deceased group and the survival 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 (mean age, 72.8 years; 439 males). Death was observed in 130 (17.7%) patients. The median (interquartile range: IQR) of age (81(74-86) years for the deceased group vs. 72 (64-79) years for the survival group, P<0.0001), frequencies of prior ischemic stroke (30% vs. 20%, P=0.0104), hemodialysis (10% vs. 2%, P=0.0002), atrial fibrillation (42% vs. 30%, P=0.0058), mRS score at discharge (4 (3-5) vs. 2 (1-4), P<0.0001), cardioembolism (45% vs. 34%, P=0.0102), creatinine level (0.80 (0.60-1.19) vs. 0.73 (0.58-0.90), P=0.0044), and BNP level (170.0 (74.0-393.0) vs. 50.0 (19.0-146.0) pg/ml, P<0.0001) were significantly higher in the deceased group than in the survival group. In multivariate analysis, age >75 years (odds ratio [OR], 2.89; 95%CI, 1.80-4.65, P=0.0001), hemidialysis (OR, 6.59; 95%CI, 2.47-17.59, P=0.0002), mRS score >3 at discharge (OR, 4.39; 95%CI, 2.77-6.97, P<0.0001), and a plasma BNP >100.0 pg/ml (OR, 3.98; 95%CI, 2.35-6.72, P<0.0001) were found to be independently associated with long-term mortality. BNP remained independent predictors of long-term mortality not only cardioembolism [BNP >200.0pg/ml (OR, 2.45; 95%CI, 1.22-4.90, P=0.0114)] but also non-cardioembolism [BNP >50.0pg/ml (OR, 4.01; 95%CI, 2.15-7.48, P=0.0001)]. Thus, the mortality rate according to the BNP level was as follows: 6% of patients with <50 pg/ml, 16% with 50 to <100 pg/ml, 27% with 100 to <200 pg/ml, 28% with 200 to <400 pg/ml, and 45% with ≥400 pg/ml. Conclusions BNP level upon admission can predict long-term mortality in ischemic stroke survivors.

Brain Natriuretic Peptide on Admission as a Biological Marker of Long-Term Mortality in Ischemic Stroke Survivors

2013 ◽  
Vol 70 (3-4) ◽  
pp. 218-224 ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Kenichiro Sakai ◽  
Shuichi Fujii ◽  
Junya Aoki ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Biological Marker ◽  
Stroke Survivors ◽  
Long Term Mortality

scholarly journals Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisha Hou ◽  
Mier Li ◽  
Ju Wang ◽  
Yawen Li ◽  
Qianwen Zheng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Exercise Duration ◽  
Stroke Recurrence ◽  
Stroke Survivors ◽  
Face To Face ◽  
Baseline Information ◽  
Exercise Type ◽  
The Relationship

AbstractThe relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.

Abstract 176: Long Term Mortality in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation According to Location and Burden of Cerebral Microbleeds

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tae-Jin Song ◽  
Jinkwon Kim ◽  
Dongbeom Song ◽  
Yong-Jae Kim ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Independent Predictor ◽  
Stroke Patients ◽  
Risk Of Death ◽  
Long Term Mortality

Background: Cerebral microbleeds (CMBs) were predictive of mortality in elderly and considered as a putative marker for risk of intracranial hemorrhage. Stroke patients with non valvular atrial fibrillation (NVAF) require anticoagulation, which increases the risk of hemorrhages. We investigated association of CMBs with the long term mortality in acute ischemic stroke patients with NVAF. Methods: During 6 years , consecutive ischemic stroke patients who had NVAF and who had undergone brain MRI with a gradient-recalled echo sequence were enrolled. Long-term mortality and causes of death were identified using data from Korean National Statistical Office. Survival analysis was performed whether the presence, number and location of CMBs were related with all causes, cardiovascular, and cerebrovascular mortality during follow-up. Results: Total 506 patients were enrolled during the study period and were followed up for median 2.5 years. CMBs were found in 30.8% of patients (156/506). Oral anticoagulation with warfarin was prescribed at discharge in 477 (82.7%) patients. During follow up, 177 (35%) patients died and cerebrovascular death was noted in 93 patients (81 ischemic stroke and 12 hemorrhagic stroke). After adjusting age, sex and significant variables in univariate analysis (p<0.1), multiple CMBs (≥5) were the independent predictor for all-cause, cardiovascular and ischemic stroke mortalities. The strictly lobar CMBs were associated with hemorrhagic stroke mortality in multivariate Cox regression analysis (HR 4.776, p=0.032) (Figure 1). Conclusions: Multiple CMBs were the independent predictor for the long term mortality in stroke patients with NVAF. Among them, patients with strictly lobar CMBs had a high risk of death due to hemorrhagic stroke. Our findings suggest that detection of CMBs in stroke patients with NVAF are of clinical relevance for predicting long term outcome and that particular concern is necessary in those with strictly lobar CMBs for their increased risk of death due to hemorrhagic stroke. Figure 1.

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