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Plasma brain natriuretic peptide as an independent predictor of in-hospital mortality after acute ischemic stroke
- Source :
- Internal medicine (Tokyo, Japan). 48(18)
- Publication Year :
- 2009
-
Abstract
- Background and Purpose We investigated whether the plasma brain natriuretic peptide (BNP) level on admission can serve as a biological marker of in-hospital death in patients with acute ischemic stroke. Methods We prospectively enrolled 335 consecutive patients (125 females; mean age, 72.3 years) with acute ischemic stroke within 24 hours of onset and measured plasma BNP on admission. Patients were divided into two groups: the deceased group, who died during hospitalization; and the survival group. The factors associated with in-hospital death were investigated by multivariate logistic regression analysis. Results Death was observed in 20 (6.0%) patients. Frequencies of atrial fibrillation, cardioembolism, the use of diuretics before ischemic stroke, the use of digitalis before ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) score on admission, glucose level, and D-dimer were significantly higher in the deceased group than in the survival group. On the other hand, albumin was significantly lower in the deceased group than in the survival group. The mean ± SD of the plasma BNP level of the deceased group was significantly higher than that of the survival group (731.5±1,070.9 vs. 213.1±384.5 pg/mL, p=0.001). The optimal cut-off level, sensitivity, and specificity of BNP levels to distinguish the deceased group from the survival group were 240 pg/mL, 75.0% and 73.0%, respectively. Multivariate logistic regression analysis demonstrated that a NIHSS score of >13 (odds ratio [OR], 4.87; 95% confidence interval, 1.54 to 15.44, p=0.007) and plasma BNP level of >240 pg/mL (OR, 4.67; 95% confidence interval, 1.28 to 17.09, p=0.020) were independent factors associated with in-hospital death. Conclusion The plasma BNP level on admission can predict in-hospital death in patients with acute ischemic stroke.
- Subjects :
- Male
medicine.medical_specialty
medicine.drug_class
Logistic regression
Risk Factors
Internal medicine
Natriuretic Peptide, Brain
Internal Medicine
medicine
Natriuretic peptide
Humans
cardiovascular diseases
Prospective Studies
Prospective cohort study
Intensive care medicine
Survival analysis
Aged
Aged, 80 and over
business.industry
Atrial fibrillation
General Medicine
Odds ratio
Middle Aged
medicine.disease
Brain natriuretic peptide
Survival Analysis
Confidence interval
Hospitalization
Stroke
Logistic Models
Cardiovascular Diseases
Multivariate Analysis
Cardiology
Female
business
Biomarkers
Subjects
Details
- ISSN :
- 13497235
- Volume :
- 48
- Issue :
- 18
- Database :
- OpenAIRE
- Journal :
- Internal medicine (Tokyo, Japan)
- Accession number :
- edsair.doi.dedup.....0aed6b7ce0d67ce95d04fa4f9a1671b4