B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure
Abstract Aims Recently, B‐type natriuretic peptide (BNP) has been attracting attention as a predictor of stroke in patients with atrial fibrillation or those with prior stroke experience. However, the association between BNP and stroke has not been examined in patients with chronic heart failure (CH...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12818 |
| _version_ | 1819081845908701184 |
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| author | Yu Hotsuki Yu Sato Akiomi Yoshihisa Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Yasuchika Takeishi |
| author_facet | Yu Hotsuki Yu Sato Akiomi Yoshihisa Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Yasuchika Takeishi |
| author_sort | Yu Hotsuki |
| collection | DOAJ |
| description | Abstract Aims Recently, B‐type natriuretic peptide (BNP) has been attracting attention as a predictor of stroke in patients with atrial fibrillation or those with prior stroke experience. However, the association between BNP and stroke has not been examined in patients with chronic heart failure (CHF). In the current study, we assessed whether BNP is associated with future occurrence of stroke in patients with CHF. Methods and results We prospectively studied 1803 consecutive patients who were admitted for decompensated HF and assessed the predictive value of circulating BNP levels for occurrence of post‐discharge stroke. A total of 69 (3.8%) patients experienced a stroke (the stroke group) during the post‐discharge follow‐up period of a median of 1150 days. The stroke group showed a higher CHADS2 score. With respect to past medical history, the stroke group had a higher prevalence of arterial hypertension, atrial fibrillation, prior stroke, and chronic kidney disease. Echocardiographic parameters showed no significant differences between the two groups. In contrast, BNP levels were significantly higher in the stroke group than in the non‐stroke group (452.1 vs. 222.7 pg/mL, P < 0.001). Multivariate Cox proportional hazard analysis indicated that BNP levels were independently associated with post‐discharge stroke (hazard ratio 2.636, 95% confidence interval 1.595–4.357, P < 0.001). The survival classification and regression tree analysis revealed that the accurate cut‐off point of BNP in predicting post‐discharge stroke was 187.7 pg/mL. We added high BNP level (BNP ≥ 180 pg/mL) as one point to CHADS2 score. The BNP‐added CHADS2 score was compared with CHADS2 score alone by using c‐statistics. The areas under the curve of CHADS2 score, BNP, and BNP‐added CHADS2 score were 0.698, 0.616, and 0.723, respectively. The predictive value of BNP‐added CHADS2 score was higher compared with those of CHADS2 score (P = 0.026). Conclusions The assessment of BNP may predict the occurrence of stroke in CHF patients used alone or in combination with established CHADS2 score. |
| first_indexed | 2024-12-21T20:07:15Z |
| format | Article |
| id | doaj.art-0849eeca70de4ddaa5926cd6f620e4f8 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-21T20:07:15Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-0849eeca70de4ddaa5926cd6f620e4f82022-12-21T18:51:48ZengWileyESC Heart Failure2055-58222020-10-01752508251510.1002/ehf2.12818B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failureYu Hotsuki0Yu Sato1Akiomi Yoshihisa2Koichiro Watanabe3Yusuke Kimishima4Takatoyo Kiko5Tetsuro Yokokawa6Satoshi Abe7Tomofumi Misaka8Takamasa Sato9Masayoshi Oikawa10Atsushi Kobayashi11Takayoshi Yamaki12Hiroyuki Kunii13Kazuhiko Nakazato14Yasuchika Takeishi15Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanAbstract Aims Recently, B‐type natriuretic peptide (BNP) has been attracting attention as a predictor of stroke in patients with atrial fibrillation or those with prior stroke experience. However, the association between BNP and stroke has not been examined in patients with chronic heart failure (CHF). In the current study, we assessed whether BNP is associated with future occurrence of stroke in patients with CHF. Methods and results We prospectively studied 1803 consecutive patients who were admitted for decompensated HF and assessed the predictive value of circulating BNP levels for occurrence of post‐discharge stroke. A total of 69 (3.8%) patients experienced a stroke (the stroke group) during the post‐discharge follow‐up period of a median of 1150 days. The stroke group showed a higher CHADS2 score. With respect to past medical history, the stroke group had a higher prevalence of arterial hypertension, atrial fibrillation, prior stroke, and chronic kidney disease. Echocardiographic parameters showed no significant differences between the two groups. In contrast, BNP levels were significantly higher in the stroke group than in the non‐stroke group (452.1 vs. 222.7 pg/mL, P < 0.001). Multivariate Cox proportional hazard analysis indicated that BNP levels were independently associated with post‐discharge stroke (hazard ratio 2.636, 95% confidence interval 1.595–4.357, P < 0.001). The survival classification and regression tree analysis revealed that the accurate cut‐off point of BNP in predicting post‐discharge stroke was 187.7 pg/mL. We added high BNP level (BNP ≥ 180 pg/mL) as one point to CHADS2 score. The BNP‐added CHADS2 score was compared with CHADS2 score alone by using c‐statistics. The areas under the curve of CHADS2 score, BNP, and BNP‐added CHADS2 score were 0.698, 0.616, and 0.723, respectively. The predictive value of BNP‐added CHADS2 score was higher compared with those of CHADS2 score (P = 0.026). Conclusions The assessment of BNP may predict the occurrence of stroke in CHF patients used alone or in combination with established CHADS2 score.https://doi.org/10.1002/ehf2.12818Heart failureB‐type natriuretic peptideStrokeCHADS2 score |
| spellingShingle | Yu Hotsuki Yu Sato Akiomi Yoshihisa Koichiro Watanabe Yusuke Kimishima Takatoyo Kiko Tetsuro Yokokawa Satoshi Abe Tomofumi Misaka Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Takayoshi Yamaki Hiroyuki Kunii Kazuhiko Nakazato Yasuchika Takeishi B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure ESC Heart Failure Heart failure B‐type natriuretic peptide Stroke CHADS2 score |
| title | B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure |
| title_full | B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure |
| title_fullStr | B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure |
| title_full_unstemmed | B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure |
| title_short | B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure |
| title_sort | b type natriuretic peptide is associated with post discharge stroke in hospitalized patients with heart failure |
| topic | Heart failure B‐type natriuretic peptide Stroke CHADS2 score |
| url | https://doi.org/10.1002/ehf2.12818 |
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