Relationship Between N-Terminal Probrain Natriuretic Peptide (NT-Pro BNP) Level, Infarct Type and Infarct Volume in Ischemic Cerebrovascular Disease

2020 ◽  
Vol 3 (2) ◽  
pp. 100-105
Author(s):  
Selma Tekin ◽  
Çağatay Hilmi Öncel ◽  
Mehmet Bülent Özdemir ◽  
Yalın Tolga Yaylalı ◽  
Işık Tekin ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Natriuretic Peptide ◽  
Transient Ischemic Attack ◽  
Infarct Volume ◽  
Lacunar Infarct ◽  
Ischemic Cerebrovascular Disease ◽  
Valuable Marker ◽  
Disease Subtypes ◽  
Ischemic Attack ◽  
Relationship Of

Background: N-terminal probrain natriuretic peptide, which is a neurohormone produced mainly by the heart, is increased in acute ischemic cerebrovascular disease. Here we aimed to investigate the relationship of N-terminal probrain natriuretic peptide levels with cerebrovascular disease subtypes, infarct volume, and prognosis in cerebrovascular disease, and to determine if N-terminal probrain natriuretic peptide could be a biomarker for ischemic cerebrovascular disease. Methods: Consecutive 105 patients with a diagnosis of acute ischemic cerebrovascular disease and 50 healthy controls were examined for serum N-terminal probrain natriuretic peptide concentration, cerebrovascular disease subtypes, infarct volumes, and clinical outcomes with the National Institute of Health Stroke Scale assessment. Results: Mean N-terminal probrain natriuretic peptide values of cardioembolic group were significantly higher than lacunar infarct group ( P < .005) and transient ischemic attack group ( P = .005). There was a relation between worsening in the National Institute of Health Stroke Scale and elevation at N-terminal probrain natriuretic peptide ( P = .001). However, between N-terminal probrain natriuretic peptide levels and infarct volume, significant correlation was not detected ( P = .44). Conclusion: N-terminal probrain natriuretic peptide can be used as a valuable marker to distinguish between cardioembolic infarct and lacunar infarct. In addition, N-terminal probrain natriuretic peptide levels might be used as a biomarker for differential diagnosis of transient ischemic attack group and to provide insight into the prognosis.

Abstract MP02: N-Terminal Pro-B-type Natriuretic Peptide and Risk of Stroke in Those With and Without Cerebrovascular Disease: The REGARDS Cohort

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kara Landry ◽  
Suzanne Judd ◽  
Dawn Kleindorfer ◽  
George Howard ◽  
Virginia Howard ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebrovascular Disease ◽  
Racial Differences ◽  
Natriuretic Peptide ◽  
Stroke Recurrence ◽  
Black And White ◽  
Hazard Ratios ◽  
History Of ◽  
Ischemic Attack ◽  
Prior Stroke

Background: N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), a commonly used marker of cardiac function, is associated with presence of stroke symptoms and is a strong risk factor for future atrial fibrillation, stroke and mortality. Little data are available on the association between NT-pro-BNP levels and stroke recurrence. Objective: We studied the relationship between NT-proBNP with the risk of future ischemic stroke across a spectrum of pre-existing cerebrovascular conditions, ranging from history of stroke symptoms, to prior transient ischemic attack (TIA), to prior stroke. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort enrolled 30 239 black and white Americans age 45 years and older in 2003-14. Among a case-cohort study sample including 1109 stroke cases and a 4311-person cohort random sample, we calculated hazard ratios of future ischemic stroke by baseline NT-proBNP stratified by presence of prior cerebrovascular conditions. Results: In the cohort sample, there were 3056 participants without any history of cerebrovascular disease, 738 with prior stroke symptoms, 196 with history of TIA and 338 with history of prior stroke. In a fully adjusted model, elevated NT-proBNP was associated with risk of stroke in participants without a pre-existing cerebrovascular condition (HR 2.32, 95% CI 1.84, 2.94), and in participants with a history of stroke symptoms (HR 1.67 95% CI 1.01, 2.78) or TIA (HR 2.66, 95% CI 1.00, 7.04), but not among those with prior stroke (HR 1.26, 95% CI 0.71, 2.21). Conclusions: These findings further support the potential for NT-proBNP testing to identify patients who are at highest risk for future stroke, although not in those with prior stroke.

scholarly journals PREVALENCE AND RISK FACTORS FOR ISCHEMIC STROKE IN LAW ENFORCEMENT OFFICERS

2021 ◽  
Vol 14 (5) ◽  
pp. 22-27
Author(s):  
ISBI S. BABAKHANOV ◽  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Law Enforcement ◽  
Arterial Hypertension ◽  
Cerebrovascular Disease ◽  
Transient Ischemic Attack ◽  
Hypertensive Crisis ◽  
Law Enforcement Officers ◽  
Research Problem ◽  
Ischemic Attack

Background. Stroke is the second leading cause of death worldwide and the third leading cause of long-term disability in adults. In law enforcement officers, stress may contribute to the development of cardiovascular disease, exacerbating a number of stroke risk factors. Aim. Study of prevalence and identification of leading risk factors for ischemic stroke in law enforcement workers. Material and methods. A retrospective analysis of case records of patients diagnosed with atrial fibrillation, acute insufficiency of cerebral circulation and transient ischemic attack who received treatment in the Republican Hospital of the Ministry of Internal Affairs of Azerbaijan from 2016 to 2020 (n=1864) was performed. Of these, 225 case records of patients with a concomitant diagnosis of ischemic stroke [(12,07±2,2)%] were selected. We studied such pathological conditions as transient ischemic attack, hypertensive cerebral crisis and chronic forms of cerebrovascular disease as risk factors for stroke. Results and discussion. We found that there were 81 [(36,0±3,2)%] cases of cerebrovascular disease among the 225 examinees, including 64 [(28,44±2,9)%] established and 17 [(7,56±3,6)%] probable cases of cerebrovascular disease. Acute forms of cerebrovascular disease often occurred together with chronic forms. (6,98±3,2)% of patients aged 40–54 years (n=129) and (17,70±3,9)% of patients aged 55–65 years (n=96) had discirculatory encephalopathy. There was a total of 6 cases of transient ischemic attack [(2,67±1,4)%] in the patients examined, of which 2 cases [(0,89±1,2)%] were «definite» and 4 cases [(1,78±0,9)%] were «possible». The overall prevalence of transient ischemic attack in patients was (2,67±1,4)%. In 75,0% of the cases detected, transient ischemic attacks were registered predominantly once. Out of the total number of all detected cases of transient ischemic attack, 4 (66,67%) cases were registered for the first time upon history taking. Arterial hypertension was registered in 198 of 225 [(88,0±2,1)%] patients examined. Hypertensive crisis during ischemic stroke was detected in 14 of 225 patients (6,22% of all patients examined) and in (17,68±2,7)% of patients with arterial hypertension (34 patients). Additionally, there were 15 [(6,67±3,83)%] cases of hypertensive cerebral crisis: 5 (2,22%) established cases of hypertensive cerebral crisis and 10 [(4,44±2,80)%] «possible» cases. Conclusion. A comprehensive study of the clinical features, course, and complications of ischemic stroke will allow us to develop new approaches to solve the urgent research problem, which is the management strategy to be applied to patients in the acute period of ischemic stroke.

Differences in Brain Natriuretic Peptide Value between Transient Ischemic Attack and Stroke Patients with Atrial Fibrillation

2011 ◽  
Vol 66 (5) ◽  
pp. 271-276 ◽  
Author(s):  
Kensaku Shibazaki ◽  
Kazumi Kimura ◽  
Yasuyuki Iguchi ◽  
Junya Aoki ◽  
Kenichiro Sakai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Transient Ischemic Attack ◽  
Stroke Patients ◽  
Ischemic Attack

scholarly journals Prediction of stroke risk in patients with transient ischemic attack: ABCD score and its derived scores

2017 ◽  
Vol 5 (12) ◽  
pp. 5093
Author(s):  
Wu Xin-Tong ◽  
Chen Jin-Bo ◽  
Xu Wen-Xiang ◽  
Lu Wen-Xian
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Ischemic Stroke ◽  
High Risk ◽  
Transient Ischemic Attack ◽  
Predictive Value ◽  
Stroke Risk ◽  
Ischemic Cerebrovascular Disease ◽  
Ischemic Attack ◽  
Abcd Score

Transient Ischemic Attack (TIA) is a high-risk signal of acute ischemic cerebrovascular disease, indicates a significant increase in the risk of ischemic stroke, especially within 7 days. Risk assessment and stratification are important in patient with TIA. A variety of simple prediction scales were developed based on the risk factors for stroke in patients with TIA, such as the California scale, ABCD scale, and ABCD2 scale. Among them, the ABCD scale score is used most commonly, but as its application becomes more and more common, the defects of this scale are also increasingly apparent. In recent years, some derived scales of ABCD score were introduced in order to improve the sensitivity and specificity of prediction. This article reviews the evolution, contents, characteristics, and predictive value of the ABCD score and its derived scales in the prediction of the stroke risk in patients with TIA.

scholarly journals Risk factors and diagnostic significance of the N-terminal pro-brain natriuretic peptide as a marker in patients with acute decompensated heart failure and diabetic kidney disease

2021 ◽  
Vol 26 (3) ◽  
pp. 4337
Author(s):  
N. A. Koziolova ◽  
A. S. Veklich
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Kidney Disease ◽  
Natriuretic Peptide ◽  
Transient Ischemic Attack ◽  
Diabetic Kidney Disease ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Diagnostic Significance ◽  
Ischemic Attack

Aim. To assess the risk factors and diagnostic significance of the N-terminal probrain natriuretic peptide (NT-proBNP) in patients with acute decompensated heart failure (ADHF) and diabetic kidney disease (DKD).Material and methods. A total of 125 patients with ADHF and type 2 diabetes (T2D) were examined. They were divided into 2 groups depending on the presence/ absence of chronic kidney disease (CKD). The first group consisted of 43 (34,4%) patients with DKD, the second — 82 (65,6%) without CKD. The inclusion criterion was the presence of ADHF and T2D. There were following exclusion criteria: cardiogenic shock, pulmonary edema, acute thromboembolic events, type 1 diabetes, prediabetes, acute coronary syndrome, stroke, prior transient ischemic attack (<1 month old), dissecting aneurysm or aortic dissection, acute valvular disorders, major surgery (<1 month old), cardiac trauma, infective endocarditis, acute hepatitis and cirrhosis, terminal CKD, alcohol abuse, non-cardiac edema, cancer, dementia and mental disorders.Results. With the development of a hypertensive crisis and an increase in diastolic blood pressure >100 mm Hg, the odds ratio (OR) and the relative risk (RR) of ADHF in patients with DKD increases by 5,1 and 4,5 times, 2,5 and 1,8 times, respectively. In the presence of grade III-V premature ventricular contractions, OR and RR of ADHF in patients with DKD were 2,6 and 1,9, respectively. OR and RR of ADHD in patients with DKD and prior stroke or transient ischemic attack were 3,8 and 3,2, respectively. Verification of anemia at a hemoglobin level of 5 mmol/l, the OR of ADHF in patients with DKD increases by 3,7 times, the OR — by 2,3 times. The NT-proBNP >1289 pg/ml is diagnostic for verifying ADHF in DKD patients with the sensitivity of 64,3% and specificity of 93,3%.Conclusion. Every third patient with ADHF and T2D is diagnosed with DKD. A certain range of risk factors for the development of ADHF in patients with DKD has been identified. As the glomerular filtration rate (GFR) decreases, the NT-proBNP level increases. With a decrease in GFR of 60 ml/min/1,73 m2 in patients with T2D, the diagnostic value of NT-proBNP >1289 pg/ml should be considered to verify ADF.

scholarly journals Pregnancy Risk Factors as Predictors of Offspring Cerebrovascular Disease

Stroke ◽  
2021 ◽  
Vol 52 (4) ◽  
pp. 1347-1354
Author(s):  
Milja Kivelä ◽  
Ina Rissanen ◽  
Eero Kajantie ◽  
Hilkka Ijäs ◽  
Harri Rusanen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Cerebrovascular Disease ◽  
Transient Ischemic Attack ◽  
Cerebrovascular Diseases ◽  
Normal Weight ◽  
Birth Complications ◽  
Increased Risk ◽  
Ischemic Attack ◽  
Pregnancy And Birth

Background and Purpose: For prevention of cerebrovascular diseases, it is important to understand the risk factors occurring early in life. The aim was to investigate the relationship of maternal and offspring anthropometrics and pregnancy complications with offspring’s risk of ischemic and hemorrhagic stroke and transient ischemic attack in adulthood. Methods: Within the population-based prospective Northern Finland Birth Cohort 1966, 11 991 persons were followed from early pregnancy to 52 years of age. Information on pregnancy and birth complications were collected starting between 24th and 28th gestational week and at birth. Ischemic and hemorrhagic strokes of the offspring were identified from national registers in Finland. Cox proportional hazard models were used to estimate the association of pregnancy and birth complications with incidence of cerebrovascular disease in the offspring, with adjustments for sex, family socioeconomic status, mother’s age, and smoking during pregnancy. Results: During 568 821 person-years of follow-up, 453 (3.8%) of the offspring had a stroke or transient ischemic attack. Small and large gestational weight gain among normal weight mothers were associated with increased ischemic stroke risk in offspring (adjusted hazard ratio [aHR], 1.93 [95% CI, 1.28–2.90] and aHR, 1.54 [95% CI, 1.02–2.31], respectively). Small birth weight for gestational age and small ponderal index were associated with increased risk for ischemic stroke (aHR, 1.95 [CI, 1.21–3.13] and aHR, 1.36 [CI, 1.04–1.77], respectively). Threatening miscarriage was also associated with increased risk of any stroke (aHR, 1.64 [CI 1.14–2.37]). Maternal smoking, hypertension, or birth complications were not associated with increased risk of cerebrovascular disease in the offspring. Conclusions: The results of this study suggest that disturbances in maternal and fetal growth during pregnancy may predispose offspring to developing cerebrovascular diseases in adulthood.

scholarly journals Early Dabigatran Treatment After Transient Ischemic Attack and Minor Ischemic Stroke Does Not Result in Hemorrhagic Transformation

2020 ◽  
Vol 47 (5) ◽  
pp. 604-611
Author(s):  
Anas Alrohimi ◽  
Kelvin Ng ◽  
Dar Dowlatshahi ◽  
Brian Buck ◽  
Grant Stotts ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Infarct Volume ◽  
Hemorrhagic Transformation ◽  
Minor Stroke ◽  
Optimal Timing ◽  
Minor Ischemic Stroke ◽  
Pre Treatment ◽  
Ischemic Attack ◽  
Ischemic Events

ABSTRACT:Objectives:The optimal timing of anticoagulation after ischemic stroke in atrial fibrillation (AF) patients is unknown. Our aim was to demonstrate the feasibility and safety of initiating dabigatran therapy within 14 days of transient ischemic attack (TIA) or minor stroke in AF patients.Patients and Methods:A prospective, multi-center registry (NCT02415855) in patients with AF treated with dabigatran within 14 days of acute ischemic stroke/TIA (National Institutes of Health Stroke Scale (NIHSS) ≤ 3) onset. Baseline and follow-up computed tomography (CT) scans were assessed for hemorrhagic transformation (HT) and graded by using European Cooperative Acute Stroke Study criteria.Results:One hundred and one patients, with a mean age of 72.4 ± 11.5 years, were enrolled. Median infarct volume was 0 ml. Median time from index event onset to dabigatran initiation was 2 days, and median baseline NIHSS was 1. Pre-treatment HT was present in seven patients. No patients developed symptomatic HT. On the day 7 CT scan, HT was present in six patients (one progressing from baseline hemorrhagic infarction type 1). Infarct volume was a predictor of incident HT (odds ratio = 1.063 [1.020–1.107], p < 0.003). All six (100%) patients with new/progressive HT were functionally independent (modified Rankin Scale (mRS) = 0–2) at 30 days, which was similar to those without HT (90%, p = 0.422). Recurrent ischemic events occurred within 30 days in four patients, two of which were associated with severe disability and death (mRS 5 and 6, respectively).Conclusion:Early dabigatran treatment did not precipitate symptomatic HT after minor stroke. Asymptomatic HT was associated with larger baseline infarct volumes. Early recurrent ischemic events may be clinically more important.

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