Correlation between the B-type Natriuretic Peptide before thrombolysis and prognosis in patients with ischemic stroke

Elevated levels of B-type natriuretic peptide (BNP) can predict the prognosis of patients with acute ischemic stroke (AIS). However, the association between BNP levels and the clinical outcome in patients with AIS receiving intravenous thrombolysis treatment remains controversial. Therefore, this study aimed to analyse the role of BNP in patients with ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) therapy.

This retrospective study involved 251 patients who were diagnosed with ischemic stroke and had undergone intravenous thrombolysis. The BNP level in blood was assessed before the treatment of thrombolysis. Outcome events include poor functional outcome, and mortality defined as modified Rankin Scale (mRS) scores of 3-6,and 6 respectively.

In multivariate logistic regression, BNP > 78 pg/mL (odds ratio, 2.726 [95% CI, 1.440-5.159]; P = 0.002) was an independent risk factor for 3-month poor outcomes in patients with ischemic stroke treated with thrombolysis, whereas BNP > 103 pg/mL (odds ratio, 4.204 [95% CI, 1.382-12.788]; P = 0.011) was significantly associated with the 3-month mortality. The area under the curve (AUC) of BNP before thrombolysis to predict poor functional outcomes at 3 months were 0.679 (95% CI, 0.618-0.737; P < 0.001), and mortality at 3 months was 0.802 (95% CI, 0.747-0.849; P < 0.001), respectively.

An early increase in BNP levels before intravenous thrombolysis was independently associated with 3-month poor outcomes and mortality. Moreover, the pre-thrombolytic BNP level may serve as a more reliable marker for predicting mortality in patients with ischemic stroke.