Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan.
J Neurol Sci. 2011 Feb 15;301(1-2):86-9. doi: 10.1016/j.jns.2010.10.017. Epub 2010 Nov 20.
Patients with atrial fibrillation (AF) and atrial thrombus are at high risk of thromboembolic events. We investigated whether BNP levels can serve as a biological marker of thrombus.
We prospectively enrolled patients with AF within 7days of an ischemic stroke and transient ischemic attack (TIA). We measured BNP levels in all patients while they underwent transesophageal echocardiography (TEE) and then assigned them to groups based on the presence (positive group) or absence (negative group) of left atrial thrombus. Factors associated with atrial thrombus were investigated using multivariate logistic regression analysis.
Of the 67 (male, n = 40; mean age, 76.5 ± 11.1 years) enrolled patients, 17 (25.4%) had left atrial thrombus. The incidence of hypertension was significantly higher in the positive, than in the negative group (88.2% vs. 58.0%, p = 0.020). The BNP level was also significantly higher in the positive, than in the negative group (median (interquartile range) 189.8 (141.4-473.2) vs. 117.9 (70.3-187.1) pg/ml, p=0.012). The optimal cut-off value, sensitivity, and specificity of BNP levels to distinguish the positive, from the negative group were 140.0 pg/ml, 76.5%, and 62.0%, respectively. Multivariate logistic regression analysis demonstrated that a BNP concentration of>140.0 pg/ml (odds ratio, 5.62; 95% CI, 1.39-22.66, p = 0.015) was an independent factor associated with thrombus.
Levels of BNP can serve as a marker of left atrial thrombus in acute ischemic stroke and TIA in patients with AF.
患有心房颤动（AF）和心房血栓的患者发生血栓栓塞事件的风险很高。我们研究了 BNP 水平是否可以作为血栓的生物标志物。
我们前瞻性地招募了在缺血性脑卒中或短暂性脑缺血发作（TIA）后 7 天内的 AF 患者。我们对所有患者进行了 BNP 水平检测，同时对他们进行了经食管超声心动图（TEE）检查，并根据左心房血栓的存在（阳性组）或不存在（阴性组）将其分为两组。使用多变量逻辑回归分析研究与心房血栓相关的因素。
在 67 名（男性，n = 40；平均年龄，76.5 ± 11.1 岁）入选患者中，有 17 名（25.4%）存在左心房血栓。阳性组的高血压发生率明显高于阴性组（88.2% vs. 58.0%，p = 0.020）。阳性组的 BNP 水平也明显高于阴性组（中位数（四分位距）189.8（141.4-473.2）vs. 117.9（70.3-187.1）pg/ml，p=0.012）。BNP 水平区分阳性组和阴性组的最佳截断值、敏感性和特异性分别为 140.0 pg/ml、76.5%和 62.0%。多变量逻辑回归分析表明，BNP 浓度>140.0 pg/ml（比值比，5.62；95%置信区间，1.39-22.66，p = 0.015）是与血栓相关的独立因素。
在 AF 合并急性缺血性脑卒中或 TIA 患者中，BNP 水平可作为左心房血栓的标志物。
