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BNP combined with echocardiographic parameters to predict the risk of cardioembolic stroke
Meng Zhang1, Yuan Wang1, Jin Wei1
1Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Insights
Brain natriuretic peptide (BNP) and left atrial diameter (LAD) effectively identify patients with acute ischemic stroke and atrial fibrillation at high risk for cardioembolic stroke. Combining BNP and LAD improves risk prediction accuracy.
Area of Science:
- Cardiology
- Neurology
- Biomarkers
Background:
- Atrial fibrillation (AF) is linked to cardiac structure and function indicators.
- Previous studies suggest a correlation between BNP and AF.
- Identifying cardioembolic stroke risk in AF patients is crucial.
Purpose of the Study:
- To investigate the role of BNP and echocardiographic parameters in identifying high-risk cardioembolic stroke in acute ischemic stroke (AIS) patients with AF.
- To assess the predictive value of BNP and Left Atrial Diameter (LAD) for cardioembolic stroke.
Main Methods:
- 436 AIS patients were categorized into AF and non-AF groups.
- Comparison of vascular risk factors, laboratory tests, and echocardiographic parameters between groups.
- Analysis of independent risk factors for cardioembolic stroke.
Main Results:
- AIS with AF group showed higher BNP, LAD, and other cardiac indicators compared to the non-AF group.
- Increased BNP, LAD, and reduced ejection fraction were independent predictors of cardioembolic stroke.
- BNP and LAD demonstrated high predictive value (AUC ~0.79), with combined use improving prediction (AUC 0.822).
Conclusions:
- BNP and LAD are effective indicators for predicting cardioembolic stroke risk in AIS patients with AF.
- Combining BNP with echocardiographic parameters, particularly LAD, significantly enhances cardioembolic stroke risk prediction.
- This combined approach offers valuable clinical utility for risk stratification.
Background:
Previous studies have found that BNP and some indicators of cardiac structure and function are closely associated with atrial fibrillation, so we aim to investigate the potential role of BNP and echocardiographic parameters to identify the acute ischemic stroke with atrial fibrillation patients who have high risks of cardioembolic stroke based on it.
Methods:
436 AIS patients were divided into an AF group and non-AF group on the basis of the electrocardiogram and Holter results. Then we compared vascular risk factors, laboratory test indicators, and echocardiographic parameters among different groups.
Results:
AIS with AF group had significantly higher age, CHD, previous medication, creatinine, d-dimer, fibrinogen, CRP, BNP, LAD, LVDd, LVDs and lower cholesterol, triglyceride, LDL and ejection fraction than the non-AF group (P < 0.05). Increased BNP, LAD, LVDd, LVDs and ejection fraction reduction were independent risk factors to predict cardioembolic stroke. BNP and LAD could be the two most effective indicators of the high risk of cardioembolic stroke. The area under the curve (AUC) of BNP and LAD were 0.791 [95%CI (0.743-0.838), p < 0.001), 0.786 [95%CI (0.739-0.833), p < 0.001]. The combined score we designed improved the prediction effect of single-indicator. The AUC of it was 0.822 with a sensitivity of 69.5% and specificity of 83.9%.There was an apparent positive correlation between BNP and LAD in AIS patients (r = 0.327, P < 0.001).
Conclusion:
BNP combined with echocardiographic parameters has outstanding value to predict the risk of cardioembolic stroke, especially for BNP and LAD.
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