NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack

Pro B-type Natriuretic Peptide and Midregional Proadrenomedullin are Associated with Incident Carotid Stenosis During Long Term Follow-up

“…35 Such measures are seldom assessed in clinical practice, however, and no relationships could be demonstrated between NT pro-BNP and the presence of carotid plaques. 13 NT pro-BNP has also been related to established cerebrovascular disease, however, both of ischaemic 36,37 and haemorrhagic 38 etiology. Increased levels of NT-pro-BNP predict both stroke mortality 37 and stroke risk after transient ischaemic attack (TIA) 35 regardless of whether the TIA was related to carotid artery stenosis or not, but it has been pointed out that such an association might be even more relevant for cardioembolic stroke.…”

It is B-type and not brain natriuretic peptide after all

“…In accordance with these studies, Rodriguez-Castro et al found significantly higher levels of NT-proBNP in patients with cardioembolic TIA compared to patients with atherothrombotic TIA. Moreover, they found significantly higher levels of NT-proBNP in patients who suffered a stroke after the TIA compared to patients who did not, again in line with the nature of cardioembolic strokes, which carry a higher risk of early and long-term recurrence [4,8]. Unfortunately, the study lacks echocardiographic or other imaging assessments that could provide more information about the structural and functional cardiac abnormalities that may have led to NT-proBNP elevation.…”

“…The ABC score, a biomarker-based risk score for stroke prediction (including NT-proBNP and high-sensitivity cardiac troponin), despite performing better compared to the clinical-based CHA 2 DS 2 -VASc score, yielded a modest accuracy in predicting the risk of stroke with a c-index of 0.68 (cindex for the CHA 2 DS 2 -VASc score 0.62, p b 0.001) [10]. In the study of Rodriguez-Castro et al [4], NT-proBNP showed also modest accuracy in predicting stroke in patients with a prior TIA with an area under the curve of 0.767, while the proposed cut-off value of 800pg/mL, which according to the authors optimally predicted stroke after TIA, had an insufficient sensitivity and specificity (64% and 79% respectively). Nevertheless, the value of 800pg/mL is higher than the cut-off value for the diagnosis of chronic HF and comparable to that for the diagnosis of acute HF in patients 50-75 years of age, as well as in patients with AF [1,3], rendering a cardiac pathology responsible for the recurrence of the cerebrovascular event quite possible.…”

B-Type Natriuretic Peptide as a Significant Brain Biomarker for Stroke Triaging Using a Bedside Point-of-Care Monitoring Biosensor

“…BNP plasma and NT-proBNP serum levels can also indicate second stroke recurrence [ 142 , 143 , 144 , 145 ]. Shibazaki K. et al [ 142 ] investigated whether BNP levels could be used as a biomarker to predict recurrent stroke in ischemic stroke survivors.…”

“…A similar conclusion was also observed in a study by Mortezabeigi H. R. et al [ 144 ], which concluded that BNP is capable of predicting TIA recurrence. Rodríguez-Castro E. et al [ 145 ] reported that a cut-off point of 800 pg/mL of NT-proBNP predicted stroke with a sensitivity of 64% and a specificity of 79% ( p < 0.001), and was independently associated with a higher risk of stroke after a TIA (OR: 6.65, p < 0.001).…”