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. 2022 Sep 30;22(1):431.
doi: 10.1186/s12872-022-02861-w.

Elevated NT-proBNP levels are associated with CTP ischemic volume and 90-day functional outcomes in acute ischemic stroke: a retrospective cohort study

Xiaozhu Shen #  1   2 , Juan Liao #  1 , Yi Jiang  2 , Yiwen Xu  2 , Mengqian Liu  2 , Xianxian Zhang  3   4 , Nan Dong  1   5 , Liqiang Yu  1 , Qingmei Chen  1 , Qi Fang  6
Affiliations

Elevated NT-proBNP levels are associated with CTP ischemic volume and 90-day functional outcomes in acute ischemic stroke: a retrospective cohort study

Xiaozhu Shen et al. BMC Cardiovasc Disord. .

Abstract

Objective: To investigate the impact of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on CTP infarct core volume and poor 90-day functional outcomes in acute ischemic stroke (AIS).

Methods: A total of 403 hospitalized patients with AIS in the Stroke Center of the First Hospital Affiliated to Soochow University were enrolled from March 2018 to January 2021. The association between NT-proBNP and clinical outcomes in acute ischemic patients was assessed by logistic regression and adjusted for confounding factors. Also, subgroup analyses were conducted based on treatment decisions.

Results: NT-proBNP was positively correlated with CTP ischemic volume (p < 0.001), infarct core volume (p < 0.001), and ischemic penumbra volume (p < 0.001). Univariate analysis showed that the influence of NT-proBNP and functional outcomes were statistically significant in model 1 (p = 0.002). This phenomenon was persistent after adjusted for age, sex, and body mass index in model 2 (p = 0.011), adjusted for SBP, current smoking, family history of stroke, hypertension, and diabetes mellitus in model 3 (p < 0.001), and adjusted for TnI, D-dimer, PLT, Cr, TC, TG, HDL-C, treatment decisions, and NIHSS score in model 4 (p = 0.027). A high NT-proBNP was associated with a high 90-days mRS score among the total population, IV rt-PA, and standardized treatment groups, but not in IV rt-PA + EVT, EVT, and EVT/IV rt-PA + EVT groups.

Conclusion: Elevated NT-proBNP levels reveal large CTP infarct core volume and poor 90-day functional outcome in AIS. NT-pro BNP is an independent risk factor for functional outcomes.

Keywords: Acute ischemic stroke; CTP perfusion; N-terminal pro-B-type natriuretic; Outcomes; Treatment decisions.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of included and excluded patients
Fig. 2
Fig. 2
CT perfusion imaging images reconstructed by post-processing software MISta. CTP infarct core volume (Red): CBF＜30%. CTP ischemic penumbra volume (Green):Mismatch. CTP ischemic volume (Red plus Green): DT>3s+
Fig. 3
Fig. 3
Three scatter plots for Spearman’s rank correlation analysis
Fig. 4
Fig. 4
Bivariate logistics regression analysis of NT-proBNP on functional outcomes. Model 1: Unadjusted. Model 2: Adjusted for age, sex, and BMI. Model 3: Additionally adjusted for SBP, current smoking, family history of stroke, hypertension, and diabetes mellitus. Model 4: Additionally adjusted for TnI, D-dimer, PLT, Cr, TC, TG, HDL-C, treatment decisions, and NIHSS score
Fig. 5
Fig. 5
Three percentage stacked bar charts for the distribution differences of 90-day mRS
Fig. 6
Fig. 6
ROC of NT-proBNP on functional outcomes
See this image and copyright information in PMC

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