Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 23;23(1):203.
doi: 10.1186/s12883-023-03222-6.

Elevated NT-proBNP predicts unfavorable outcomes in patients with acute ischemic stroke after thrombolytic therapy

Zhuang Zhu #  1   2 , Bilal Muhammad #  2 , Bo Du #  2 , Ning Gu  1   2 , Tian-Yue Meng  1   2 , Shu Kan  2 , Ying-Feng Mu  2 , Yan-Bo Cheng  2 , Shi-Guang Zhu  3 , De-Qin Geng  4
Affiliations

Elevated NT-proBNP predicts unfavorable outcomes in patients with acute ischemic stroke after thrombolytic therapy

Zhuang Zhu et al. BMC Neurol. .

Abstract

Objective: Few studies correlated n-terminal pro-brain natriuretic peptide (NT-proBNP) with early neurological deterioration (END) and prognosis of acute ischaemic stroke (AIS) patients with rt-PA intravenous thrombolysis. Therefore this study aimed to investigate the relationship between NT-proBNP and END, and prognosis after intravenous thrombolysis in patients with AIS.

Methods: A total of 325 patients with AIS were enrolled. We performed the natural logarithm transformation on the NT-proBNP [ln(NT-proBNP)]. Univariate and multivariate logistic regression analyses were performed to assess the relationship between ln(NT-proBNP) and END, and prognosis and receiver operating characteristic (ROC) curves were used to show the sensitivity and specificity of NT-proBNP.

Results: After thrombolysis, among 325 patients with AIS, 43 patients (13.2%) developed END. In addition, three months follow-up showed a poor prognosis in 98 cases (30.2%) and a good prognosis in 227 cases (69.8%). Multivariate logistic regression analysis showed that ln(NT-proBNP) was an independent risk factor for END (OR = 1.450,95%CI:1.072 ~ 1.963, P = 0.016) and poor prognosis at three months follow-up (OR = 1.767, 95%CI: 1.347 ~ 2.317, P < 0.001) respectively. According to ROC curve analysis, ln(NT-proBNP) (AUC 0.735, 95%CI: 0.674 ~0.796, P < 0.001) had a good predictive value for poor prognosis, with a predictive value of 5.12 and sensitivity and specificity of 79.59% and 60.35% respectively. When combined with NIHSS to predict END(AUC 0.718, 95%CI: 0.631 ~ 0.805, P < 0.001) and poor prognosis(AUC 0.780, 95%CI: 0.724 ~ 0.836, P < 0.001), the predictive value of the model is further improved.

Conclusion: NT-proBNP is independently associated with END and poor prognosis in patients with AIS following intravenous thrombolysis and has a particular predictive value for END and poor prognosis.

Keywords: Acute ischemic stroke; Early neurological deterioration; Intravenous thrombolysis; NT-proBNP; Prognosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig.1
Fig.1
Flow chart for retrospective enrolment of patients
Fig.2
Fig.2
The distribution of ln(NT-proBNP) in patients with END and poor prognosis. ***P < 0.001
Fig. 3
Fig. 3
ROC curve of predictors of END and poor prognosis in AIS patients
Fig. 4
Fig. 4
These aspects may suggest that NT-proBNP is a biomarker for predicting END and poor prognosis
See this image and copyright information in PMC

References

    1. Tu WJ, Zhao Z, Yin P, et al. Estimated burden of stroke in China in 2020. JAMA Netw Open. 2023;6(3):e231455. doi: 10.1001/jamanetworkopen.2023.1455. - DOI - PMC - PubMed
    1. GBD 2019 Stroke Collaborators Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20(10):795–820. doi: 10.1016/S1474-4422(21)00252-0. - DOI - PMC - PubMed
    1. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2019;50(12):344–344e418. doi: 10.1161/STR.0000000000000211. - DOI - PubMed
    1. Liu YL, Yin HP, Qiu DH, et al. Multiple hypointense vessels on susceptibility-weighted imaging predict early neurological deterioration in acute ischaemic stroke patients with severe intracranial large artery stenosis or occlusion receiving intravenous thrombolysis[J] Stroke Vasc Neurol. 2020;5(4):361–367. doi: 10.1136/svn-2020-000343. - DOI - PMC - PubMed
    1. Sabir Rashid A, Huang-Link Y, Johnsson M, et al. Predictors of early neurological deterioration and functional outcome in acute ischemic stroke: the importance of large artery disease, hyperglycemia and inflammatory blood biomarkers[J] Neuropsychiatr Dis Treat. 2022;18:1993–2002. doi: 10.2147/NDT.S365758. - DOI - PMC - PubMed

Substances