Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
Atherosclerosis. 2009 Nov;207(1):298-303. doi: 10.1016/j.atherosclerosis.2009.04.029. Epub 2009 May 3.
Structural heart diseases including atrial fibrillation are precursors for ischemic stroke. Plasma B-type natriuretic peptide (BNP) has been reported to be increased in patients with several types of structural heart diseases. However, the predictive value of plasma BNP for ischemic stroke remains unknown. We have studied the predictive ability of plasma BNP for future development of stroke in community dwelling adults.
Subjects of this community-based study were recruited from the general population (n=13,466). Plasma BNP levels and cardiovascular risk factors were determined at baseline. The incidence of ischemic stroke in the cohort was identified from regional stroke registry data. A multivariate Cox regression analysis was performed to analyze the relationship between plasma BNP levels and the risk of stroke.
During a mean follow-up period of 2.8 years, 102 participants (65 males, 37 females) experienced a first ischemic stroke. In men, after adjustment for classical cardiovascular risk factors and atrial fibrillation, the hazard ratio (HR) for ischemic stroke was significantly elevated in the highest plasma BNP quartile (HR=2.38; 95% CI=1.07-5.29). In women, the relationship between plasma BNP levels and risk of ischemic stroke was of marginal significance after adjusting for the presence or absence of atrial fibrillation (HR=3.03; 95% CI=0.84-10.92, P=0.09).
Elevated plasma BNP levels predict the risk of ischemic stroke within men from the general population.
结构性心脏病(包括房颤)是缺血性卒中的前驱因素。已有研究报道,多种结构性心脏病患者的血浆 B 型利钠肽(BNP)水平升高。然而,血浆 BNP 对缺血性卒中的预测价值仍不清楚。我们研究了血浆 BNP 对社区居住成年人未来发生卒中的预测能力。
本研究为基于社区的研究,对象选自普通人群(n=13466)。在基线时测定了血浆 BNP 水平和心血管危险因素。通过区域卒中登记数据确定队列中缺血性卒中的发生情况。采用多变量 Cox 回归分析,分析血浆 BNP 水平与卒中风险的关系。
在平均 2.8 年的随访期间,102 名参与者(65 名男性,37 名女性)发生了首次缺血性卒中。在男性中,在校正了经典心血管危险因素和房颤后,最高血浆 BNP 四分位数的缺血性卒中风险比(HR)显著升高(HR=2.38;95%CI=1.07-5.29)。在女性中,在校正房颤的有无后,血浆 BNP 水平与缺血性卒中风险的关系具有统计学意义(HR=3.03;95%CI=0.84-10.92,P=0.09)。
升高的血浆 BNP 水平可预测普通男性人群中缺血性卒中的风险。