101. Moderate Levels of N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Increased Risks of Total and Ischemic Strokes among Japanese: The Circulatory Risk in Communities Study
- Author
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Yuji Shimizu, Hironori Imano, Tomoko Sankai, Kazumasa Yamagishi, Yasuhiko Kubota, Tetsuya Ohira, Akihiko Kitamura, Takeo Okada, Kenji Ebihara, Mitsumasa Umesawa, Hiroyasu Iso, Isao Muraki, Mina Hayama-Terada, Renzhe Cui, and Masahiko Kiyama
- Subjects
medicine.medical_specialty ,Lacunar stroke ,Proportional hazards model ,business.industry ,medicine.drug_class ,Biochemistry (medical) ,Hazard ratio ,Atrial fibrillation ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,Internal medicine ,Internal Medicine ,Natriuretic peptide ,Cardiology ,Medicine ,cardiovascular diseases ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,hormones, hormone substitutes, and hormone antagonists ,030217 neurology & neurosurgery - Abstract
Aim N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. Methods We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. Results During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14-28.0) for ischemic stroke and 6.81 (1.11-41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. Conclusion We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.
- Published
- 2020