High Plasma Brain Natriuretic Polypeptide Level as a Marker of Risk for Thromboembolism in Patients With Nonvalvular Atrial Fibrillation

Shimizu, Hiromi; Murakami, Yo; Inoue, Shinichi; Ohta, Y.; Nakamura, Ko; Katoh, Harumi; Sakne, Takeshi; Takahashi, Nobuyuki; Ohata, Shuzo; Sakaguchi, Takashi; Ishibashi, Yutaka; Shimada, Toshio

doi:10.1161/hs0402.105657

Cited by 84 publications

(58 citation statements)

References 41 publications

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“…20,21 Such patients show higher plasma BNP levels than control subjects, and patients with atrial fibrillation plus clinical evidence of thromboembolism have higher BNP levels than those patients with atrial fibrillation alone. 22 High levels of DD, products of degradation of cross-linked fibrin by plasmin, are also an independent predictor of cardioembolic stroke, thus confirming the results of previous reports. Various studies have shown that the coagulation and fibrinolytic systems are activated in cerebral ischemia, and DD is the most frequently used indicator of blood coagulation activation.…”

Section: Bnp and Dd For Cardioembolic Strokesupporting

confidence: 87%

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Montaner¹,

Perea-Gainza²,

Delgado³

et al. 2008

Stroke

272

212

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Background and Purpose-Because there is no biologic marker offering precise information about stroke etiology, many patients receive a diagnosis of undetermined stroke even after all available diagnostic tests are done, precluding correct treatment. Methods-To examine the diagnostic value of a panel of biochemical markers to differentiate stroke etiologies, consecutive acute stroke patients were prospectively evaluated. Brain computed tomography, ultrasonography, cardiac evaluations, and other tests were done to identify an etiologic diagnosis according to TOAST classification. Blood samples were drawn on Emergency Department arrival (Ͻ24 hours) to test selected biomarkers: C-reactive protein, D-dimer, soluble receptor for advanced glycation end products, matrix metalloproteinase-9, S-100b, brain natriuretic peptide (BNP), neurotrophin-3, caspase-3, chimerin, and secretagogin (assayed by ELISA). 6.7, PϽ0.001). A model combining clinical and biochemical data had a sensitivity of 66.5% and a specificity of 91.3% for predicting cardioembolism. Conclusions-Using a combination of biomarkers may be a feasible strategy to improve the diagnosis of cardioembolic stroke in the acute phase, thus rapidly guiding other diagnostic tests and accelerating the start of optimal secondary prevention. Results-Of

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Section: Bnp and Dd For Cardioembolic Strokesupporting

confidence: 87%

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Montaner¹,

Perea-Gainza²,

Delgado³

et al. 2008

Stroke

272

212

View full text Add to dashboard Cite

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“…A more recent study confirms these findings [38]. BNP has also been associated with embolism in patients with atrial fibrillation [39,40].…”

Section: Biomarkers Of Ischemic Stroke Etiologymentioning

confidence: 69%

Blood Biomarkers of Ischemic Stroke

2011

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This review provides a summary of the protein and RNA biomarkers that have been studied for the diagnosis and assessment of ischemic stroke. Many of the biomarkers identified relate to the pathophysiology of ischemic stroke, including ischemia of CNS tissue, acute thrombosis and inflammatory response. These biomarkers are summarized by their intended clinical application in ischemic stroke including diagnosis, prediction of stroke severity and outcome, and stratification of patients for stroke therapy. Among the biomarkers discussed are recent whole genome studies using RNA expression profiles to diagnose ischemic stroke and stroke etiology. Though many candidate blood based biomarkers for ischemic stroke have been identified, none are currently used in clinical practice. With further well designed study and careful validation, the development of blood biomarkers to improve the care of patients with ischemic stroke may be achieved.

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“…It has also been reported that BNP level can predict thromboembolism in patients with NVAF. 19 Further study is required to confirm the prognostic value of BNP level on LAA thrombus.…”

Section: Prevalence Of Laa Thrombi During Anticoagulationmentioning

confidence: 99%

Left Atrial Appendage Thrombi Formation in Japanese Non-Valvular Atrial Fibrillation Patients During Anticoagulation Therapy　― Warfarin vs. Direct Oral Anticoagulants ―

Kawabata

Goya

Sasaki

et al. 2017

Circ J

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Background: Atrial fibrillation (AF) is a common cardiac arrhythmia, associated with increased cardiovascular morbidity and mortality including thromboembolic events. The aims of this study were to assess the prevalence of left atrial appendage (LAA) thrombi in Japanese non-valvular atrial fibrillation (NVAF) patients undergoing preprocedural transesophageal echocardiography (TEE) during anticoagulation therapy, and to compare the efficacy of warfarin and direct oral anticoagulants (DOAC). Methods and Results:This retrospective study reviewed records of 559 consecutive NVAF patients (445 men; age, 62±11 years) undergoing preprocedural TEE following at least 3 weeks of anticoagulation therapy. Of these, 275 patients had non-paroxysmal AF (49%). LAA thrombus was observed in 15 patients (2.7%). The prevalence of LAA thrombi was similar between the DOAC group (2.6%) and the warfarin group (2.8%, P=0.86). No patients with CHA2DS2-VASc score=0, or paroxysmal AF without prior stroke or transient ischemic attack, had LAA thrombi. On univariate analysis, non-paroxysmal AF, structural heart disease, antiplatelet therapy, larger left atrium, higher brain natriuretic peptide (BNP), reduced LAA flow, and higher CHA2DS2-VASc score were all associated with LAA thrombi. On multivariate analysis, BNP ≥173 pg/mL remained the only independent predictor of LAA thrombi.Conclusions: LAA thrombi were found in 2.7% of Japanese NVAF patients scheduled for procedures despite ongoing oral anticoagulation therapy. Incidence of thrombi was similar for patients on DOAC and on warfarin.

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High Plasma Brain Natriuretic Polypeptide Level as a Marker of Risk for Thromboembolism in Patients With Nonvalvular Atrial Fibrillation

Cited by 84 publications

References 41 publications

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Blood Biomarkers of Ischemic Stroke

Left Atrial Appendage Thrombi Formation in Japanese Non-Valvular Atrial Fibrillation Patients During Anticoagulation Therapy　― Warfarin vs. Direct Oral Anticoagulants ―

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High Plasma Brain Natriuretic Polypeptide Level as a Marker of Risk for Thromboembolism in Patients With Nonvalvular Atrial Fibrillation

Cited by 84 publications

References 41 publications

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Etiologic Diagnosis of Ischemic Stroke Subtypes With Plasma Biomarkers

Blood Biomarkers of Ischemic Stroke

Left Atrial Appendage Thrombi Formation in Japanese Non-Valvular Atrial Fibrillation Patients During Anticoagulation Therapy ― Warfarin vs. Direct Oral Anticoagulants ―

Contact Info

Product

Resources

About

Left Atrial Appendage Thrombi Formation in Japanese Non-Valvular Atrial Fibrillation Patients During Anticoagulation Therapy　― Warfarin vs. Direct Oral Anticoagulants ―