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Direct comparison of prognostic ability of cardiac biomarkers for cardiogenic stroke and clinical outcome in patients with stroke

  • Yoichiro Otaki
  • Tetsu WatanabeEmail author
  • Naohito Sato
  • Toru Shirata
  • Hayato Tsuchiya
  • Masahiro Wanezaki
  • Harutoshi Tamura
  • Satoshi Nishiyama
  • Takanori Arimoto
  • Hiroki Takahashi
  • Tetsuro Shishido
  • Keita Morikane
  • Masafumi Watanabe
Original Article

Abstract

Despite many recent advances in medicine, cardiogenic stroke is still a health problem with a high mortality rate. Cardiac biomarkers have been reported to be useful indicators for cardiogenic stroke and subsequent cerebrovascular events. However, there are no data directly comparing the cardiac biomarkers in stroke patients. We measured atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hsTnT) levels and performed transthoracic and transesophageal echocardiography in 282 stroke patients. There were 108 cases of cardiogenic stroke and 47 cases of major adverse cardiovascular and cerebrovascular events (MACCE) during the follow-up period. Association with left atrial function and left atrial appendage function appeared somewhat stronger for BNP and NT-proBNP than ANP and hsTnT. Multivariate logistic analysis demonstrated that cardiac biomarkers excluding ANP were significantly associated with cardiogenic stroke in stroke patients, multivariate Cox’s proportional hazards regression analysis demonstrated that all biomarkers were significantly associated with MACCE after adjustment for confounding risk factors. Receiver operating characteristic curve analysis showed that the C indices of BNP and NT-proBNP for cardiogenic stroke and MACCE were almost equal, but significantly greater than those of ANP and hsTnT. Both BNP and NT-proBNP levels are useful predictors of cardiogenic stroke and subsequent MACCE superior to ANP and hsTnT in stroke patients.

Keywords

Cardiac biomarkers NT-proBNP Cardiogenic stroke Major adverse cardiovascular and cerebrovascular events 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

380_2019_1345_MOESM1_ESM.pdf (317 kb)
Supplemental figure 1. Associations of BNP/NT-proBNP with LAEF (A) and LAA area (B). LAEF, left atrial ejection fraction; LAA area, left atrial appendage area. Supplemental figure 2. Associations between BNP and NT-proBNP (PDF 317 kb)

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Yoichiro Otaki
    • 1
  • Tetsu Watanabe
    • 1
    Email author
  • Naohito Sato
    • 2
  • Toru Shirata
    • 2
  • Hayato Tsuchiya
    • 1
  • Masahiro Wanezaki
    • 1
  • Harutoshi Tamura
    • 1
  • Satoshi Nishiyama
    • 1
  • Takanori Arimoto
    • 1
  • Hiroki Takahashi
    • 1
  • Tetsuro Shishido
    • 1
  • Keita Morikane
    • 3
  • Masafumi Watanabe
    • 1
  1. 1.Department of Cardiology, Pulmonology, and NephrologyYamagata University School of MedicineYamagataJapan
  2. 2.Division of Clinical LaboratoryYamagata University HospitalYamagataJapan
  3. 3.Division of Clinical Laboratory and Infection ControlYamagata University HospitalYamagataJapan

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