Predictive value of plasma B-type natriuretic peptide for ischemic stroke: A community-based longitudinal study

• Published in: Atherosclerosis 2009-11, Vol.207 (1), p.298-303
• Main Authors: Takahashi, Tomohiro, Nakamura, Motoyuki, Onoda, Toshiyuki, Ohsawa, Masaki, Tanno, Kozo, Itai, Kazuyoshi, Sakata, Kiyomi, Sakuma, Masafumi, Tanaka, Fumitaka, Makita, Shinji, Yoshida, Yuki, Ogawa, Akira, Kawamura, Kazuko, Okayama, Akira
• Format: Article
• Language: English
• Subjects: Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biological Factors - blood; Blood and lymphatic vessels; Brain Ischemia - blood; Brain Ischemia - epidemiology; Brain Ischemia - etiology; Cardiology. Vascular system; Cardiovascular; Female; Humans; Incidence; Japan - epidemiology; Kaplan-Meier Estimate; Longitudinal Studies; Male; Medical sciences; Middle Aged; Natriuretic peptide; Natriuretic Peptide, Brain - blood; Neurology; Population; Predictive Value of Tests; Proportional Hazards Models; Prospective Studies; Registries; Risk; Risk Assessment; Risk Factors; Sex Factors; Stroke; Stroke - blood; Stroke - epidemiology; Stroke - etiology; Up-Regulation; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.04.029

Abstract Objective Structural heart diseases including atrial fibrillation are precursors for ischemic stroke. Plasma B-type natriuretic peptide (BNP) has been reported to be increased in patients with several types of structural heart diseases. However, the predictive value of plasma BNP for ischemic stroke remains unknown. We have studied the predictive ability of plasma BNP for future development of stroke in community dwelling adults. Methods Subjects of this community-based study were recruited from the general population ( n = 13,466). Plasma BNP levels and cardiovascular risk factors were determined at baseline. The incidence of ischemic stroke in the cohort was identified from regional stroke registry data. A multivariate Cox regression analysis was performed to analyze the relationship between plasma BNP levels and the risk of stroke. Results During a mean follow-up period of 2.8 years, 102 participants (65 males, 37 females) experienced a first ischemic stroke. In men, after adjustment for classical cardiovascular risk factors and atrial fibrillation, the hazard ratio (HR) for ischemic stroke was significantly elevated in the highest plasma BNP quartile (HR = 2.38; 95% CI = 1.07–5.29). In women, the relationship between plasma BNP levels and risk of ischemic stroke was of marginal significance after adjusting for the presence or absence of atrial fibrillation (HR = 3.03; 95% CI = 0.84–10.92, P = 0.09). Conclusion Elevated plasma BNP levels predict the risk of ischemic stroke within men from the general population.