Value of N-terminal pro-Brain Natriuretic Peptide in Acute Stage of Ischemic Stroke

Choi, Yun Ju; Lee, Seung Han; Choi, Kang Ho; Lee, Kee Ra; Choi, Seong Min; Park, Man Seok; Kim, Byeong Chae; Kim, Myeong Kyu; Cho, Ki Hyun

Abstract

BACKGROUND: Brain natriuretic peptide (BNP) is expected to play a role in hemodynamic modulation. Its biologically inactive fragment, the 76-amino-acid N-terminal proBNP (NT-pro-BNP), was known as one of the biologic markers of congestive heart failure and other clinical situations. But, there are controversies about clinical significance of NT-pro-BNP in ischemic stroke. This study was performed to find the clinical significance of NT- pro-BNP in early stage of acute ischemic stroke.
METHODS
NT-pro-BNP levels were measured in 610 consecutive patients who admitted to the department of neurology at Chonnam National University Hospital. 205 patients were excluded due to incomplete follow-up period (more than 2 weeks), systemic infection, and etc. 286 ischemic stroke patients and 119 patients as control subjects were enrolled. NT-pro-BNP levels between stroke group and control were analyzed. When the patients in stroke group had more than 300 pg/mL of NT-pro-BNP, they were regarded as high group and the others were low group. National Institute of Health Stroke Scale (NIHSS) was checked at admission and 2 weeks later. Relationship between changes of NIHSS and the NT-pro-BNP level was also investigated.
RESULTS
The NT-pro-BNP levels were significantly increased in ischemic stroke patients (830.87 pg/mL) compared with control group (378.27 pg/mL) (p=0.002). And the high levels of NT-pro-BNP in stroke patients were related to severity on admission and cardioembolic infarction. But there was no correlation between NT-pro-BNP and improvement of NIHSS.
CONCLUSIONS
In this study, significant relationship between the severity of ischemic stroke and NT-pro-BNP was found. But NT-pro-BNP was not related to early prognosis of ischemic stroke.