B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis

B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis Publisher Pubmed

Llombart V¹ ; Antolinfontes A¹ ; Bustamante A¹ ; Giralt D¹ ; Rost NS² ; Furie K³ ; Shibazaki K⁴ ; Biteker M⁵ ; Castillo J⁶ ; Rodriguezyanez M⁶ ; Fonseca AC⁷ ; Watanabe T⁸ ; Purroy F⁹ ; Zhixin W¹⁰ Show All Authors

Llombart V¹
Antolinfontes A¹
Bustamante A¹
Giralt D¹
Rost NS²
Furie K³
Shibazaki K⁴
Biteker M⁵
Castillo J⁶
Rodriguezyanez M⁶
Fonseca AC⁷
Watanabe T⁸
Purroy F⁹
Zhixin W¹⁰
Etgen T¹¹
Hosomi N¹²
Jafarian Kerman SR¹³
Sharma JC^{14, 15}
Knauer C¹⁶
Santamarina E¹⁷
Giannakoulas G¹⁸
Garciaberrocoso T¹
Montaner J¹

Show Affiliations

1. Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Neurovascular Unit, Department of Neurology, Universitat Autonoma de Barcelona, Pg. Vall d'Hebron 119-129, Barcelona, 08035, Spain
2. Acute Stroke Services, Massachusetts General Hospital, J. Philip Kistler Stroke Research Center, Boston, United States
3. Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, United States
4. Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
5. Department of Cardiology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
6. Department of Neurology, Clinical University, Hosp. University of Santiago de Compostela, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
7. Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal
8. Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, Yamagata, Japan
9. Department of Neurology, Stroke Unit, Hospital Universitari Arnau de Vilanova, Grup Neurociencies Cliniques IRBLleida, Lleida, Spain
10. Department of Emergency Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
11. Department of Neurology, Kliniken Sudostbayern-Klinikum Traunstein, Traunstein, Germany
12. Department of Psychiatry and Psychotherapy, Technische Universitat Munchen, Munchen, Germany
13. Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
14. Tehran University of Medical Sciences and Health Services, Tehran, Iran
15. Stroke and Parkinson's Disease Services, Lincoln County Hospital, University of Nottingham, Nottingham, United Kingdom
16. Department of Neurology, University of Ulm, Ulm, Germany
17. Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Barcelona, Spain
18. Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece

Source: Stroke Published:2015

Abstract

Background and Purpose - Determining the underlying cause of stroke is important to optimize secondary prevention treatment. Increased blood levels of natriuretic peptides (B-type natriuretic peptide/N-terminal pro-BNP [BNP/NT-proBNP]) have been repeatedly associated with cardioembolic stroke. Here, we evaluate their clinical value as pathogenic biomarkers for stroke through a literature systematic review and individual participants' data meta-analysis. Methods - We searched publications in PubMed database until November 2013 that compared BNP and NT-proBNP circulating levels among stroke causes. Standardized individual participants' data were collected to estimate predictive values of BNP/NT-proBNP for cardioembolic stroke. Dichotomized BNP/NT-proBNP levels were included in logistic regression models together with clinical variables to assess the sensitivity and specificity to identify cardioembolic strokes and the additional value of biomarkers using area under the curve and integrated discrimination improvement index. Results - From 23 selected articles, we collected information of 2834 patients with a defined cause. BNP/NT-proBNP levels were significantly elevated in cardioembolic stroke until 72 hours from symptoms onset. Predictive models showed a sensitivity >90% and specificity >80% when BNP/NT-proBNP were added considering the lowest and the highest quartile, respectively. Both peptides also increased significantly the area under the curve and integrated discrimination improvement index compared with clinical models. Sensitivity, specificity, and precision of the models were validated in 197 patients with initially undetermined stroke with final pathogenic diagnosis after ancillary follow-up. Conclusions - Natriuretic peptides are strongly increased in cardioembolic strokes. Future multicentre prospective studies comparing BNP and NT-proBNP might aid in finding the optimal biomarker, the best time point, and the optimal cutoff points for cardioembolic stroke identification. © 2015 American Heart Association, Inc.

2. Microrna: Relevance to Stroke Diagnosis, Prognosis, and Therapy, Journal of Cellular Physiology (2018)

Experts (# of related papers)

Hamid Reza Mirzaei (1)

Style	Citing Format
MLA	Llombart V, et al.. "B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis." Stroke, vol. 46, no. 5, 2015, pp. 1187-1195.
APA	Llombart V, Antolinfontes A, Bustamante A, Giralt D, Rost NS, Furie K, Shibazaki K, Biteker M, Castillo J, Rodriguezyanez M, Fonseca AC, Watanabe T, Purroy F, Zhixin W, Etgen T, Hosomi N, Jafarian Kerman SR, Sharma JC, Knauer C, ... Montaner J (2015). B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis. Stroke, 46(5), 1187-1195.
Chicago	Llombart V, Antolinfontes A, Bustamante A, Giralt D, Rost NS, Furie K, Shibazaki K, et al.. "B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis." Stroke 46, no. 5 (2015): 1187-1195.
Harvard	Llombart V et al. (2015) 'B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis', Stroke, 46(5), pp. 1187-1195.
Vancouver	Llombart V, Antolinfontes A, Bustamante A, Giralt D, Rost NS, Furie K, et al.. B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis. Stroke. 2015;46(5):1187-1195.
BibTex	@article{ author = {Llombart V and Antolinfontes A and Bustamante A and Giralt D and Rost NS and Furie K and Shibazaki K and Biteker M and Castillo J and Rodriguezyanez M and Fonseca AC and Watanabe T and Purroy F and Zhixin W and Etgen T and Hosomi N and Jafarian Kerman SR and Sharma JC and Knauer C and Santamarina E and Giannakoulas G and Garciaberrocoso T and Montaner J}, title = {B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis}, journal = {Stroke}, volume = {46}, number = {5}, pages = {1187-1195}, year = {2015} }
RIS	TY - JOUR AU - Llombart V AU - Antolinfontes A AU - Bustamante A AU - Giralt D AU - Rost NS AU - Furie K AU - Shibazaki K AU - Biteker M AU - Castillo J AU - Rodriguezyanez M AU - Fonseca AC AU - Watanabe T AU - Purroy F AU - Zhixin W AU - Etgen T AU - Hosomi N AU - Jafarian Kerman SR AU - Sharma JC AU - Knauer C AU - Santamarina E AU - Giannakoulas G AU - Garciaberrocoso T AU - Montaner J TI - B-Type Natriuretic Peptides Help in Cardioembolic Stroke Diagnosis JO - Stroke VL - 46 IS - 5 SP - 1187 EP - 1195 PY - 2015 ER -

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