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
Meta-Analysis
. 2025 Jun 27;20(6):e0322816.
doi: 10.1371/journal.pone.0322816. eCollection 2025.

Association between N-terminal pro-brain natriuretic peptide levels and outcomes of ischemic stroke: A systematic review and meta-analysis

Yehong Zhang  1 , Jingjia Zheng  1 , Fangyong Xu  1
Affiliations
Meta-Analysis

Association between N-terminal pro-brain natriuretic peptide levels and outcomes of ischemic stroke: A systematic review and meta-analysis

Yehong Zhang et al. PLoS One. .

Abstract

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) was identified as an important biomarker of cardiovascular disease, in ischemic stroke. This study intends to assess the association of NT-proBNP levels with clinical outcomes of patients ischemic stroke patients.

Methods: A comprehensive search of MEDLINE, Web of Science, ScienceDirect, and Cochrane CENTRAL electronic databases was done for papers published till April 2024 and reporting on the levels of NT-proBNP in patients with ischemic stroke. Outcomes of interest included mortality (all-cause and cardiovascular) and neurological, and functional outcomes. A random-effects meta-analysis model was used, and final estimates were reported as pooled odds ratio (OR) with 95% confidence interval (CI).

Results: Elevated NT-proBNP levels were significantly linked to increased all-cause (pooled OR = 2.322, 95% CI: 1.718 to 2.925) and cardiovascular mortality (pooled OR = 1.797, 95% CI: 1.161 to 2.433). Higher NT-proBNP levels were also related to poorer functional outcomes (pooled OR = 1.129, 95% CI: 1.041 to 1.217). Patients with higher NT-proBNP levels had somewhat worse neurological outcomes (pooled OR = 1.317, 95% CI: 0.859 to 1.774). Considerable heterogeneity was detected across the studies (I² > 40% in most analyses).

Conclusion: NT-proBNP levels may serve as a robust predictor of mortality and offer potential utility in predicting functional recovery in ischemic stroke patients. The integration of NT-proBNP measurement into clinical settings may be beneficial for risk stratification and management of stroke survivors.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
Fig 2
Fig 2. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and all-cause mortality amongst ischaemic stroke patients (unadjusted estimates).
Fig 3
Fig 3. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and all-cause mortality amongst ischaemic stroke patients (adjusted estimates).
Fig 4
Fig 4. Subgroup analysis based on study design showing the association between N-terminal pro brain natriuretic peptide levels and all-cause mortality amongst ischaemic stroke patients.
Fig 5
Fig 5. Subgroup analysis based on duration of follow-up showing the association between N-terminal pro brain natriuretic peptide levels and all-cause mortality amongst ischaemic stroke patients.
Fig 6
Fig 6. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and cardiovascular mortality amongst ischaemic stroke patients.
Fig 7
Fig 7. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and neurological outcomes amongst ischaemic stroke patients.
Fig 8
Fig 8. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and haemorrhagic transformation amongst ischaemic stroke patients.
Fig 9
Fig 9. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and functional outcomes amongst ischaemic stroke patients (unadjusted estimates).
Fig 10
Fig 10. Forest plot showing the association between N-terminal pro brain natriuretic peptide levels and functional outcomes amongst ischaemic stroke patients (adjusted estimates).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Katan M, Luft A. Global Burden of Stroke. Semin Neurol. 2018;38(2):208–11. doi: 10.1055/s-0038-1649503 - DOI - PubMed
    1. Saceleanu VM, Toader C, Ples H, Covache-Busuioc R-A, Costin HP, Bratu B-G, et al. Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations. Biomedicines. 2023;11(10):2617. doi: 10.3390/biomedicines11102617 - DOI - PMC - PubMed
    1. Rossi R, Jabrah D, Douglas A, Prendergast J, Pandit A, Gilvarry M, et al. Investigating the Role of Brain Natriuretic Peptide (BNP) and N-Terminal-proBNP in Thrombosis and Acute Ischemic Stroke Etiology. Int J Mol Sci. 2024;25(5):2999. doi: 10.3390/ijms25052999 - DOI - PMC - PubMed
    1. Fu S, Ping P, Wang F, Luo L. Synthesis, secretion, function, metabolism and application of natriuretic peptides in heart failure. J Biol Eng. 2018;12:2. doi: 10.1186/s13036-017-0093-0 - DOI - PMC - PubMed
    1. Shen X, Zhang X, Liu M, Dong N, Liao J, Zhou G, et al. NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke. Dis Markers. 2023;2023:5318012. doi: 10.1155/2023/5318012 - DOI - PMC - PubMed