NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack

• Published in: International journal of cardiology Vol. 298; pp. 93 - 97
• Main Authors: Rodríguez-Castro, Emilio, Hervella, Pablo, López-Dequidt, Iria, Arias-Rivas, Susana, Santamaría-Cadavid, María, López-Loureiro, Ignacio, da Silva-Candal, Andrés, Pérez-Mato, María, Sobrino, Tomás, Campos, Francisco, Castillo, José, Rodríguez-Yáñez, Manuel, Iglesias-Rey, Ramón
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2020
• Subjects: Biomarker; NT-pro-BNP; Secondary prevention; Stroke; Transient ischemic attack; NT-pro-BNP; Secondary prevention; Stroke; Biomarker; Transient ischemic attack
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2019.06.056

Elevated levels of B-type natriuretic peptide (BNP) and NT-pro-BNP can predict an increased risk of cardiovascular events and ischemic stroke. The limited reliability to predict the risk of stroke after a transient ischemic attack (TIA) justifies the objective of our study to determine the role of NT-pro-BNP in patients with TIAs. From our prospective stroke registry, we performed a retrospective study in all patients with the diagnosis of TIA admitted to the Stroke Unit of our Hospital between January 2008 and March 2018. NT-pro-BNP was determined in the first hours after TIA. The endpoint was the development of stroke during the follow-up. 381 patients were included. Mean time of follow-up was 36.8 (±16.4) months. 224 patients were hospitalized due to a stroke during the follow-up, and 157 were not. NT-pro-BNP serum levels were higher in patients who suffered a stroke compared to those who did not (p ≪ 0.001). We also found greater levels of this marker the earlier the stroke happened (p = 0.024). A cut-off point of 800 pg/mL of NT-pro-BNP predicted a stroke with a sensitivity of 64% and a specificity of 79% (p ≪ 0.001), and was independently associated with higher risk of stroke after a TIA (OR: 6.65, p ≪ 0.001). This association persisted for different etiopathogenic TIA groups (cardioembolic: OR 26.12, p ≪ 0.001; undetermined: OR 4.87, p = 0.006; atherothrombotic: OR 1.67, p = 0.044). The early determination of NT-pro-BNP is a simple and very useful alternative to predict the prognosis after TIA regardless of the etiopathogenesis of the TIA. •High levels of NT-pro-BNP after TIA predict an increased risk of stroke.•The highest levels of NT-pro-BNP after TIA are associated with earlier stroke.•NT-pro-BNP analysis is a simple and useful complement to assess prognosis after TIA.