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NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack

2019; Elsevier BV; Volume: 298; Linguagem: Inglês

10.1016/j.ijcard.2019.06.056

1874-1754

Emilio Rodríguez‐Castro, Pablo Hervella, Iria López‐Dequidt, Susana Arias-Rivas, María Santamaría-Cadavid, Ignacio López-Loureiro, Andrés da Silva‐Candal, María Pérez‐Mato, Tomás Sobrino, Francisco Campos, José Castillo, Manuel Rodríguez‐Yáñez, Ramón Iglesias‐Rey,

Stroke Rehabilitation and Recovery

Elevated levels of B-type natriuretic peptide (BNP) and NT-pro-BNP can predict an increased risk of cardiovascular events and ischemic stroke. The limited reliability to predict the risk of stroke after a transient ischemic attack (TIA) justifies the objective of our study to determine the role of NT-pro-BNP in patients with TIAs.From our prospective stroke registry, we performed a retrospective study in all patients with the diagnosis of TIA admitted to the Stroke Unit of our Hospital between January 2008 and March 2018. NT-pro-BNP was determined in the first hours after TIA. The endpoint was the development of stroke during the follow-up.381 patients were included. Mean time of follow-up was 36.8 (±16.4) months. 224 patients were hospitalized due to a stroke during the follow-up, and 157 were not. NT-pro-BNP serum levels were higher in patients who suffered a stroke compared to those who did not (p ≪ 0.001). We also found greater levels of this marker the earlier the stroke happened (p = 0.024). A cut-off point of 800 pg/mL of NT-pro-BNP predicted a stroke with a sensitivity of 64% and a specificity of 79% (p ≪ 0.001), and was independently associated with higher risk of stroke after a TIA (OR: 6.65, p ≪ 0.001). This association persisted for different etiopathogenic TIA groups (cardioembolic: OR 26.12, p ≪ 0.001; undetermined: OR 4.87, p = 0.006; atherothrombotic: OR 1.67, p = 0.044).The early determination of NT-pro-BNP is a simple and very useful alternative to predict the prognosis after TIA regardless of the etiopathogenesis of the TIA.