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- Title
N-terminal probrain natriuretic peptide as a biomarker of cardioembolic stroke.
- Authors
Fonseca, Ana Catarina; Matias, Joaquim Sampaio; Pinho e Melo, Teresa; Falcão, Filipa; Canhão, Patrícia; Ferro, José M.
- Abstract
Background and purpose N-terminal probrain natriuretic peptide, which is mainly produced by the heart, is increased in acute stroke. We aimed to determine if N-terminal probrain natriuretic peptide could be a biomarker for ischemic stroke with a cardioembolic cause. Methods Consecutive sample of acute stroke patients admitted to a Stroke Unit. Ischemic stroke subtype was classified using the TOAST classification. Blood samples were drawn within 72 h after stroke onset. Serum N-terminal probrain natriuretic peptide concentration was measured using an electrochemiluminescence immunoassay. Mean values of N-terminal probrain natriuretic peptide were compared between patients with hemorrhagic stroke vs. ischemic stroke, cardioembolic stroke vs. noncardioembolic stroke, cardioembolic stroke with atrial fibrillation vs. noncardioembolic stroke using t-test. Receiver operating characteristic curves were used to test the ability of N-terminal probrain natriuretic peptide values to identify cardioembolic stroke and cardioembolic stroke with atrial fibrillation. Results Ninety-two patients were included (66 with ischemic stroke) with a mean age of 58·6 years. Twenty-eight (42·4%) ischemic strokes had a cardioembolic cause. Mean N-terminal probrain natriuretic peptide values for cardioembolic stroke were significantly higher ( P<0·001) (491·6; 95% confidence interval 283·7-852·0 pg/ml) than for noncardioembolic ischemic stroke (124·7; 86·3-180·2 pg/ml). The area under the receiver operating characteristic curve for N-terminal probrain natriuretic peptide in cardioembolic stroke was 0·77. The cut-off point with the highest sensitivity and specificity was set at 265·5 pg/ml (71·4% and 73·7% respectively). The area under the curve of N-terminal probrain natriuretic peptide for cardioembolic stroke related to atrial fibrillation was 0·92, cut-off was set at 265·5 pg/ml (sensitivity 94·4%, specificity 72·9%). Conclusion N-terminal probrain natriuretic peptide is a biomarker with a good accuracy to predict ischemic stroke of cardioembolic cause, namely associated with atrial fibrillation.
- Subjects
CEREBROVASCULAR disease patients; BIOMARKERS; PEPTIDES; ISCHEMIA; BLOOD circulation disorders
- Publication
International Journal of Stroke, 2011, Vol 6, Issue 5, p398
- ISSN
1747-4930
- Publication type
Article
- DOI
10.1111/j.1747-4949.2011.00606.x