Predictive value of serum initial brain natriuretic peptide and troponin on functional prognosis in noncardiogenic patients with anterior and posterior circulation cerebral infarction

• Published in: Arquivos de neuro-psiquiatria Vol. 80; no. 10; pp. 985 - 993
• Main Authors: Lu, Wan-Ting, Du, Wen-Ting, Lu, De-Sheng, You, Jie, Li, Hong-yan
• Format: Journal Article
• Language: English; Portuguese
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01.10.2022; Arquivos de Neuro-Psiquiatria; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Biomarkers - blood; brain infarction; Brain natriuretic peptide; c-reactive protein; C-Reactive Protein - analysis; Calcium-binding protein; Cerebral blood flow; Cerebral infarction; Cerebral Infarction - diagnosis; Diabetes mellitus; Embolism; Factor analysis; Humans; infarction, anterior cerebral artery; Ischemia; Magnetic resonance imaging; natriuretic peptide, brain; Natriuretic Peptide, Brain - blood; Neuroimaging; NEUROSCIENCES; Original; Original Article; Peptides; Prognosis; Prospective Studies; PSYCHIATRY; Regression analysis; Serum levels; Stroke; Troponin; Troponin - blood; Troponina; Prognosis; C-Reactive Protein; Proteína C-Reativa; Prognóstico; Embolia; Infarto da Artéria Cerebral Anterior; Brain Infarction; Infarction, Anterior Cerebral Artery; Embolism; Peptídeo Natriurético Encefálico; Troponin; Natriuretic Peptide, Brain; Infarto Encefálico
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1055/s-0042-1755270

Abstract Background  Brain natriuretic peptide (BNP) and troponin have a close relationship with cardiogenic cerebral embolism (CCE), but their relationship with noncardiogenic patients with anterior circulation ischemia (ACI) and posterior circulation ischemia (PCI) is not clear. Objective  To explore the predictive value of serum initial BNP and troponin on the functional prognosis of patients with noncardiogenic ACI and PCI. Methods  Consecutive patients with first-episode cerebral infarction within 12 hours of symptom onset were enrolled in the present 1-year prospective cohort study. Serum levels of BNP and troponin were collected within 12 hours of onset. Infarction location was classified as ACI and PCI by magnetic resonance imaging (MRI). According to the modified Rankin Scale (mRS) score at 90 days after onset, ACI and PCI cases were respectively divided into a good prognosis group (mRS score between 0 and 2) and a poor prognosis group (mRS score between 3 and 6). The general state of health and results of laboratory examinations and other auxiliary examinations of all patients were recorded. Single-factor analysis and multivariate logistic regression analysis were used to assess the relationship between serum levels of BNP, troponin, and functional outcome. Results  The multivariate logistic regression found that higher levels of initial BNP (odds ratio [OR] = 1.024; 95% confidence interval [CI]: 1.006–1.041; p  = 0.007) and C-reactive protein (CRP) (OR = 1.184; 95%CI: 1.024–1.369; p  = 0.022) were independent predictors of poor functional prognosis of noncardiogenic PCI at 90 days after onset after adjusting for age, gender, ethnicity, history of hypertension and of diabetes. Conclusions  The levels of initial BNP and CRP were related to poor functional outcomes in noncardiogenic PCI patients at 3 months, independent of troponin.