Department of Neurology, Nippon Medical School, Tokyo, Japan; Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Saitama, Japan.
Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
J Neurol Sci. 2024 Mar 15;458:122935. doi: 10.1016/j.jns.2024.122935. Epub 2024 Feb 15.
Brain natriuretic peptides (BNP) are an important diagnostic and prognostic marker in patients with heart failure. However, the relationship between BNP levels and stroke severity in patients with atrial fibrillation (AF) remains unelucidated. In this study, we aimed to investigate the association between stroke severity at admission and BNP levels.
In this prospective observational study, we used data from 513 patients with AF and acute ischemic stroke treated with oral anticoagulants (OAC) registered in the Multicenter Prospective Analysis of Stroke Patients Taking Oral Anticoagulants study. The patients were divided into two groups: high-BNP (≥200 pg/mL) and low-BNP level (<200 pg/mL) groups. We compared the clinical characteristics between the two groups and determined the effect of BNP levels on stroke severity on admission.
Among the 513 enrolled patients, 248 (females, n = 30; median age, 82 years) and 265 (females, n = 76; median age, 71 years) were assigned to the high- and low-BNP level groups, respectively. The high-BNP level group had a higher proportion of patients with severe stroke (National Institutes of Health Stroke Scale score, ≥10) on admission (49.2% vs. 32.8%, p = 0.002) and major vessel occlusion (57.5% vs. 39.2%, p < 0.0001) than that had by the low-BNP level group. Multivariate analysis showed that high BNP level was independently associated with severe stroke on admission (odds ratio 1.07, 95% confidence interval 1.00-1.15; p = 0.0478).
High BNP level compared with low BNP level was associated with severe stroke and major vessel occlusion, even before OAC treatment.
脑利钠肽（BNP）是心力衰竭患者重要的诊断和预后标志物。然而，心房颤动（AF）患者的 BNP 水平与卒中严重程度之间的关系仍不清楚。在这项研究中，我们旨在探讨入院时卒中严重程度与 BNP 水平之间的关系。
这是一项前瞻性观察性研究，我们使用了口服抗凝剂（OAC）治疗的 513 例 AF 合并急性缺血性卒中患者的 Multicenter Prospective Analysis of Stroke Patients Taking Oral Anticoagulants 研究数据。患者被分为两组：高 BNP（≥200 pg/mL）和低 BNP 水平组（<200 pg/mL）。我们比较了两组之间的临床特征，并确定了 BNP 水平对入院时卒中严重程度的影响。
在纳入的 513 例患者中，248 例（女性，n=30；中位年龄 82 岁）和 265 例（女性，n=76；中位年龄 71 岁）被分配到高和低 BNP 水平组。入院时高 BNP 水平组的患者中严重卒中（NIHSS 评分≥10）的比例较高（49.2%比 32.8%，p=0.002），大血管闭塞的比例也较高（57.5%比 39.2%，p<0.0001）。多变量分析显示，高 BNP 水平与入院时严重卒中独立相关（比值比 1.07，95%置信区间 1.00-1.15；p=0.0478）。
与低 BNP 水平相比，高 BNP 水平与严重卒中及大血管闭塞相关，甚至在开始 OAC 治疗之前。
