N-Terminal Pro-Brain Natriuretic Peptide and Short-Term Mortality After Ischemic Stroke

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.

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Admission Hemoglobin Is Prognostic for In-Hospital Mortality in Oldest-Old Patients with Acute Ischemic Stroke

Gerontology ◽

10.1159/000514678 ◽

2021 ◽

pp. 1-8

Author(s):

Mingquan Li ◽

Xiaoyun Liu ◽

Liumin Wang ◽

Lei Shu ◽

Liqin Luan ◽

...

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Hospital Stay ◽

Acute Ischemic Stroke ◽

Oldest Old ◽

Final Analysis ◽

Short Term ◽

Old Patients ◽

Short Term Mortality ◽

Tertiary Hospitals

Introduction: Anemia is a common condition encountered in acute ischemic stroke, and only a few pieces of evidence has been produced suggesting its possible association with short-term mortality have been produced. The study sought to assess whether admission anemia status had any impact on short-term clinical outcome among oldest-old patients with acute ischemic stroke. Materials and Methods: A retrospective review of Electronic Medical Recording System was performed in 2 tertiary hospitals. Data, from the oldest-old patients aged > = 80 years consecutively admitted with a diagnosis of acute ischemic stroke between January 1, 2015, and December 31, 2019, were analyzed. Admission hemoglobin was used as indicator for anemia and severity. Univariate and multivariate regression analyses were used to compare in-hospital mortality and length of in-hospital stay in different anemia statuses and normal hemoglobin patients. Results: A total of 705 acute ischemic stroke patients were admitted, and 572 were included in the final analysis. Of included patients, 240 of them were anemic and 332 nonanemic patients. A statistical difference between the 2 groups was found in in-hospital mortality (p < 0.001). After adjustment for baseline characteristics, the odds ratio value of anemia for mortality were 3.91 (95% confidence intervals (CI) 1.60–9.61, p = 0.003) and 7.15 (95% CI: 1.46–34.90, p = 0.015) in moderate and severely anemic patients, respectively. Similarly, length of in-hospital stay was longer in anemic patients (21.64 ± 6.17 days) than in nonanemic patients (19.08 ± 5.48 days, p < 0.001). Conclusions: Increased severity of anemia may be an independent risk factor for increased in-hospital mortality and longer length of stay in oldest-old patients with acute ischemic stroke.

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N-terminal Pro-brain Natriuretic Peptide plasma levels are Associated With a Short-Term Diagnosis of Cancer in Patients with Coronary Artery Disease

10.21203/rs.3.rs-135088/v1 ◽

2020 ◽

Author(s):

José Tuñón ◽

Álvaro Aceña ◽

Ana Pello ◽

Sergio Ramos-Cillán ◽

Juan Martínez-Milla ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Plasma Levels ◽

High Sensitivity ◽

Short Term ◽

Artery Disease

Abstract Background N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels are increased in patients with cancer. In this paper we test whether NT-proBNP may identify patients who are going to receive a future cancer diagnosis (CD) in the short term. Methods We studied 962 patients with stable coronary artery disease and free of cancer and heart failure at baseline. NT-proBNP, galectin-3, monocyte chemoattractant protein-1, high-sensitivity C-reactive protein, high-sensitivity cardiac troponin I (hsTnI), and calcidiol (vitamin D) plasma levels were assessed. The primary outcome was new CD. Results After 5.40 (2.81-6.94) years of follow-up, 59 patients received a CD. NT-proBNP [HR 1.036 CI (1.015-1.056) per increase in 100 pg/ml; p=0.001], previous atrial fibrillation [HR 3.140 CI (1.196-8.243); p=0.020], and absence of previous heart failure [HR 0.067 CI (0.006-0.802); p=0.033] were independent predictors of a receiving a CD in first three years of follow-up. None of the variables analyzed predicted a CD beyond this time. A previous history of heart failure was present in 3.3% of patients receiving a CD in the first three years of follow-up, in 0.0% of those receiving this diagnosis beyond three years, and in 12.3% of patients not developing cancer (p=0.036). Conclusions In patients with coronary artery disease, NT-proBNP is an independent predictor of CD in the first three years of follow-up but not later, suggesting that it could be detecting subclinical undiagnosed cancers. The existence of previous heart failure does not account for these differences. New studies in large populations are needed to confirm these findings.

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