NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke

Abstract

Methods: In this study, 326 hospitalized patients with acute anterior circulation ischemic stroke (AACIS) were included. A comparison of the clinical characteristics of those with and without AF was conducted. The Spearman rank correlation was used for the correlation analysis of plasma NT-proBNP level, regional leptomeningeal collateral (rLMC) score, and computed tomography perfusion (CTP) status in the AF and non-AF groups. An analysis of multivariate linear regression was used to determine how plasma NT-proBNP level, rLMC score, and CTP status influenced the score on the NIHSS.

Results: There was a greater plasma NT-proBNP level in the AF group compared with the non-AF group, an increased CTP volume (including CTP ischemic volume, CTP infarct core volume, and CTP ischemic penumbra volume (P = 0.002)), higher NIHSS score on admission, and lower rLMC score (P < 0.001 for the remaining parameters). A negative correlation exists between plasma NT-proBNP level and rLMC score (r = -0.156, P = 0.022), but a positive correlation exists between plasma NT-proBNP level and both CTP ischemic volume and CTP infarct core volume (r = 0.148, P = 0.003) in the AF group, but not in the non-AF group. Multivariate linear regression analysis demonstrated that NT-proBNP, CTP ischemic penumbra volume, and rLMC score were associated with NIHSS score, and NT-proBNP was positively associated with NIHSS scores (95% confidence interval (CI), 0.000-0.002; P = 0.004) in the AF group, whatever in the unadjusted model or adjusted models, but not in the nonlarge artery atherosclerosis (LAA) group.

Conclusion: In AACIS patients with AF, NT-proBNP level negatively correlated with collateral status, positively with CTP ischemic volume, and positively with NIHSS score.

Figure 1

Flow diagram of included and excluded patients.

Figure 2

MIStar automatic software was used to calculate ischemic volume. CTP ischemic volume (red): DT > 3 s⁺. CTP infarct core volume (green): CBF < 30%. CTP ischemic penumbra volume (green minus red): mismatch: acute hypoperfused lesion volume minus the infarct core volume.

Figure 3

Scatter plots illustrating results of the Spearman rank correlation analysis (red, AF group; blue, non-AF group). (a) The correlations between plasma NT-proBNP level and rLMC score in the AF and non-AF groups. (b) The correlations between plasma NT-proBNP level and CTP ischemic volume in the AF and non-AF groups. (c) The correlations between plasma NT-proBNP level and CTP infarct core volume in the AF and non-AF groups. (d) The correlations between plasma NT-proBNP level and CTP ischemic penumbra volume in the AF and non-AF groups.