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. 2015 Dec 15;4(12):e002072.
doi: 10.1161/JAHA.115.002072.

N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) Levels are Increased in Patients With Transient Ischemic Attack Accompanied by Nonfocal Symptoms

Gerben J J Plas  1 , Susanne D Jurg  1 , Marjolein Brusse-Keizer  2 , Diederik W J Dippel  3 , Peter J Koudstaal  3 , Heleen M den Hertog  4
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N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) Levels are Increased in Patients With Transient Ischemic Attack Accompanied by Nonfocal Symptoms

Gerben J J Plas et al. J Am Heart Assoc. .

Abstract

Background: Transient nonfocal neurological symptoms may serve as markers of cardiac dysfunction. We assessed whether serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, a biomarker of cardiac disease, are increased in patients with transient ischemic attack (TIA) accompanied by nonfocal symptoms and in patients with attacks of nonfocal symptoms (transient neurological attack [TNA]).

Methods and results: We included 15 patients with TNA, 69 with TIA accompanied by nonfocal symptoms, 58 with large-vessel TIA, 32 with cardioembolic TIA, and 46 age- and sex-matched healthy control participants. Serum NT-proBNP levels were determined within 1 week after the attack. We compared log-transformed NT-proBNP levels of patients with cardioembolic TIAs and mixed or nonfocal TNAs, with those of patients with noncardioembolic TIAs as a reference group. Adjustments for age, sex, atrial fibrillation, and a history of nonischemic heart disease were made with a multiple linear regression model. Compared with large-vessel TIA (mean 14.2 pmol/L), mean NT-proBNP levels were significantly higher in patients with TIA accompanied by nonfocal symptoms (40.5 pmol/L, P=0.049) and with cardioembolic TIA (123.5 pmol/L; P=0.004) after adjustments for age, sex, atrial fibrillation, and a history of nonischemic heart disease. Patients with TNA also had higher mean NT-proBNP levels (20.8 pmol/L, P=0.38) than those with large-vessel TIA, but this difference was not statistically significant.

Conclusion: NT-proBNP levels are increased in patients with TIA accompanied by nonfocal symptoms.

Keywords: N‐terminal pro–brain natriuretic peptide; cardiac origin; nonfocal symptoms; transient neurological attacks; transient nonfocal neurological symptoms.

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Figures

Figure 1
Figure 1
Mean NT‐proBNP levels in various event groups. NT‐proBNP indicates N‐terminal pro–brain natriuretic peptide; TIA, transient ischemic attack; TNA, transient neurological attack.
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