Zhang Ke-Jia, Jin Hang, Xu Rui, Zhang Peng, Guo Zhen-Ni, Yang Yi
Department of Neurology, China National Comprehensive Stroke Center, The First Hospital of Jilin University, Changchun, China.
Department of Neurology, Clinical Trial and Research Center for Stroke, The First Hospital of Jilin University, Changchun, China.
Front Mol Neurosci. 2021 Nov 22;14:758915. doi: 10.3389/fnmol.2021.758915. eCollection 2021.
N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are a promising biomarker for predicting stroke outcomes; however, their prognostic validity is not well-understood in patients who have undergone intravenous thrombolysis. This study was designed to evaluate the prognostic value of NT-proBNP levels in patients with acute ischemic stroke treated with intravenous thrombolysis. Patients with ischemic stroke who underwent intravenous thrombolysis between April 2015 and December 2020 were analyzed. Demographic information, information related to intravenous thrombolysis, medical history, and laboratory test results were collected. Outcomes, such as hemorrhagic transformation, early neurologic deterioration, poor 3-month functional outcomes, and 3-month mortality were recorded. Correlations between NT-proBNP levels and the above outcomes were analyzed, an individualized prediction model based on NT-proBNP levels for functional outcomes was developed, and a nomogram was drafted. A total of 404 patients were included in the study. Elevated NT-proBNP levels were independently associated with hemorrhagic transformation, poor 3-month functional outcomes, and 3-month mortality, while early neurological deterioration was not. An association between NT-proBNP levels and hemorrhagic transformation was noted. An individualized prediction model for poor functional outcomes was established, which was composed of ln(NT-proBNP), National Institutes of Health Stroke Scale (NIHSS), and baseline glucose, with good discrimination [area under the curve (AUC) 0.764] and calibration ( > 0.05). To the best of our knowledge, this is the first report on the association between NT-proBNP levels and hemorrhagic transformation in patients who have undergone intravenous thrombolysis. The 3-month functional outcomes and mortality were found to be associated with NT-proBNP levels. An individualized prediction model based on NT-proBNP levels to predict the 3-month functional outcomes was established. Our results suggest that NT-proBNP levels could be used as a prognostic biomarker in patients with acute ischemic stroke treated with intravenous thrombolysis.
N 端前脑钠肽（NT-proBNP）水平是预测卒中预后的一种很有前景的生物标志物；然而，在接受静脉溶栓治疗的患者中，其预后有效性尚未得到充分了解。本研究旨在评估 NT-proBNP 水平在接受静脉溶栓治疗的急性缺血性卒中患者中的预后价值。对 2015 年 4 月至 2020 年 12 月期间接受静脉溶栓治疗的缺血性卒中患者进行了分析。收集了人口统计学信息、与静脉溶栓相关的信息、病史和实验室检查结果。记录了出血转化、早期神经功能恶化、3 个月功能预后不良和 3 个月死亡率等结局。分析了 NT-proBNP 水平与上述结局之间的相关性，建立了基于 NT-proBNP 水平的功能预后个体化预测模型，并绘制了列线图。本研究共纳入 404 例患者。NT-proBNP 水平升高与出血转化、3 个月功能预后不良和 3 个月死亡率独立相关，而与早期神经功能恶化无关。注意到 NT-proBNP 水平与出血转化之间存在关联。建立了功能预后不良的个体化预测模型，该模型由 ln(NT-proBNP)、美国国立卫生研究院卒中量表（NIHSS）和基线血糖组成，具有良好的区分度[曲线下面积（AUC）为 0.764]和校准度（>0.05）。据我们所知，这是关于接受静脉溶栓治疗的患者中 NT-proBNP 水平与出血转化之间关联的首份报告。发现 3 个月功能预后和死亡率与 NT-proBNP 水平相关。建立了基于 NT-proBNP 水平预测 3 个月功能预后的个体化预测模型。我们的结果表明，NT-proBNP 水平可作为接受静脉溶栓治疗的急性缺血性卒中患者的预后生物标志物。
