Validation of the use of B-type natriuretic peptide point-of-care test platform in preliminary recognition of cardioembolic stroke patients in the ED

Wu, Zhixin; Zhao, Mingming; He, Miao; Zeng, Hongke; Tan, Feng; Li, Kuangyi; Chen, Shenglong; Han, Qianpeng; Wang, Qiaosheng

doi:10.1016/j.ajem.2015.01.013

Cited by 15 publications

(30 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, over the past years, different biomarkers have been examined for use in ischemic stroke etiology classification [ 49 ]. Several recent studies concluded that BNP and NT-proBNP elevated serum levels show a correlation with cardioembolic stroke [ 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 ]. In addition, BNP and NT-proBNP showed correlation with an atrial fibrillation (AF) condition, abnormal heart rhythm (arrhythmia), that was found to be associated with cardioembolic stroke.…”

Section: B-type Natriuretic Peptide Expression In Stroke Pathologymentioning

confidence: 99%

“…Strengthening these findings, Wu Z. et al [ 121 ] examined the use of a POC test platform for plasma BNP detection in preliminary recognition of cardioembolic stroke patients in the ED. The results showed that the mean BNP concentration was significantly higher in the cardioembolic group than in the other 3 stroke subtypes: (1) large artery atherosclerosis; (2) small artery occlusion (e.g., lacunar); and (3) stroke of other determined etiology or stroke of other undetermined etiology ( p < 0.01).…”

Section: B-type Natriuretic Peptide Expression In Stroke Pathologymentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2020

View full text Add to dashboard Cite

Stroke is a widespread condition that causes 7 million deaths globally. Survivors suffer from a range of disabilities that affect their everyday life. It is a complex condition and there is a need to monitor the different signals that are associated with it. Stroke patients need to be rapidly diagnosed in the emergency department in order to allow the admission of the time-limited treatment of tissue plasminogen activator (tPA). Stroke diagnostics show the use of sophisticated technologies; however, they still contain limitations. The hidden information and technological advancements behind the utilization of biomarkers for stroke triaging are significant. Stroke biomarkers can revolutionize the way stroke patients are diagnosed, monitored, and how they recover. Different biomarkers indicate different cascades and exhibit unique expression patterns which are connected to certain pathologies in the human body. Over the past decades, B-type natriuretic peptide (BNP) and its derivative N-terminal fragment (NT-proBNP) have been increasingly investigated and highlighted as significant cardiovascular biomarkers. This work reviews the recent studies that have reported on the usefulness of BNP and NT-proBNP for stroke triaging. Their classification association is also presented, with increased mortality in stroke, correlation with cardioembolic stroke, and an indication of a second stroke recurrence. Moreover, recent scientific efforts conducted for the technological advancement of a bedside point-of-care (POC) device for BNP and NT-proBNP measurements are discussed. The conclusions presented in this review may hopefully assist in the major efforts that are currently being conducted in order to improve the care of stroke patients.

show abstract

Section: B-type Natriuretic Peptide Expression In Stroke Pathologymentioning

confidence: 99%

Section: B-type Natriuretic Peptide Expression In Stroke Pathologymentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

show abstract

“…BNP reflects on the ventricular condition with a half-life of 20 min, while NT-proBNP showed a half-life of 1–2 h [ 129 ]. Multiple studies reported that both BNP and NT-proBNP elevated serum levels are associated with cardioembolic stroke [ 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ]. Additionally, they were found to be associated with atrial fibrillation (AF) condition, an abnormal heart rhythm (arrhythmia), that increases the risk of ischemic stroke and was also found to be associated with cardioembolic stroke [ 130 ].…”

Section: Biomarkers That Best Indicate Cardioembolic Etiologymentioning

confidence: 99%

“…Additionally, Nakamura M. et al [ 79 ] reported that BNP predicted cardioembolic stroke (area under the receiver operating characteristic (AUC ROC) = 81%)). In addition to these findings, Wu Z. et al [ 65 ] examined a point-of-care (POC) test for plasma BNP detection in the emergency department (ED), to promote initial recognition of cardioembolic stroke patients. BNP concentration was higher in the cardioembolic group ( p < 0.01), a plasma BNP level higher than 66.5 pg/mL was associated with cardioembolic stroke (sensitivity = 76% and a specificity = 87%).…”

Section: Biomarkers That Best Indicate Cardioembolic Etiologymentioning

confidence: 99%

Blood-Based Biomarkers Are Associated with Different Ischemic Stroke Mechanisms and Enable Rapid Classification between Cardioembolic and Atherosclerosis Etiologies

et al. 2020

View full text Add to dashboard Cite

Stroke is a top leading cause of death, which occurs due to interference in the blood flow of the brain. Ischemic stroke (blockage) accounts for most cases (87%) and is further subtyped into cardioembolic, atherosclerosis, lacunar, other causes, and cryptogenic strokes. The main value of subtyping ischemic stroke patients is for a better therapeutic decision-making process. The current classification methods are complex and time-consuming (hours to days). Specific blood-based biomarker measurements have promising potential to improve ischemic stroke mechanism classification. Over the past decades, the hypothesis that different blood-based biomarkers are associated with different ischemic stroke mechanisms is increasingly investigated. This review presents the recent studies that investigated blood-based biomarker characteristics differentiation between ischemic stroke mechanisms. Different blood-based biomarkers are specifically discussed (b-type natriuretic peptide, d-dimer, c-reactive protein, tumor necrosis factor-α, interleukin-6, interleukin-1β, neutrophil–lymphocyte ratio, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and apolipoprotein A), as well as the different cut-off values that may be useful in specific classifications for cardioembolic and atherosclerosis etiologies. Lastly, the structure of a point-of-care biosensor device is presented, as a measuring tool on-site. The information presented in this review will hopefully contribute to the major efforts to improve the care for stroke patients.

show abstract

“…Serum levels of NT-proBNP have been shown to elevate in cardioembolic stroke patients up to 72 h from onset of symptoms (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Increased NT-proBNP levels have been indicative of cardioembolic stroke with a sensitivity of 75.6% and specificity of 87.4% (21). Moreover, the mean serum NT-proB-NP value has been significantly higher in cardioembolic stroke patients (P<0.001) (491.6 pg mL -1 ; 95% confidence interval 283.7-852.0 pg mL -1 ) than that in non-cardioembolic ischemic stroke patients (124.7 pg mL -1 ; 86.3-180.2 pg mL -1 ) (33).…”

Section: Introductionmentioning

confidence: 99%

Electrochemical impedimetric detection of stroke biomarker NT-proBNP using disposable screen-printed gold electrodes

Sinawang

Harpaz

Fajs

et al. 2017

The EuroBiotech Journal

View full text Add to dashboard Cite

Stroke is the second top leading cause of death globally. It is caused by an abrupt interruption of blood flow to the brain. In that course, brain natriuretic peptide (BNP) and its derivative N-terminal pro b-type natriuretic peptide (NT-proBNP), neurohormones produced mainly by the heart ventricles in response to excessive stretching of cardiomyocytes (heart muscle cells), are proven to be good biomarkers for heart failure diagnosis. Moreover, there is growing clinical interest of the use of NT-proBNP for stroke diagnosis and prognosis because it is significantly associated with cardioembolic stroke and secondary stroke reoccurrence, with sensitivity >90% and specificity >80%. However, in diagnostic settings, there is still a need to address the encountered analytical problems, particularly assay specificity and set up. In this study, a novel approach for NT-proBNP detection is demonstrated using an electrochemical immunoassay method. A label-free impedimetry immunosensor for stroke biomarker was developed using modified disposable screen-printed gold electrodes (SPGE) hosting specific anti-NT-proBNP capture antibody. The performance of our immunosensor was studied in the presence of NT-proBNP in both buffered and mock (porcine) plasma samples. A linear relation between the relative total resistance (ΔRtot) responses and the NT-proBNP concentrations in buffer was observed in a range from 0.1 to 5 ng mL-1 with a correlation coefficient (R2) of 0.94656. Overall, the biosensor has demonstrated the capability to quantitate NT-proBNP and differentiate such concentrations in a low concentration range, especially among 0, 0.1, 0.5, 1, and 3 ng mL-1 in plasma samples within 25 min. This range is valuable not only for classifying cardioembolic stroke (higher or equal to 0.5 ng mL-1), but also predicting the risk of secondary stroke reoccurrence (higher than 0.255 ng mL-1). Our biosensor has the potential to be used as an easy-to-use point-of-care test that is both accurate and affordable.

show abstract

Validation of the use of B-type natriuretic peptide point-of-care test platform in preliminary recognition of cardioembolic stroke patients in the ED

Cited by 15 publications

References 33 publications

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

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

Blood-Based Biomarkers Are Associated with Different Ischemic Stroke Mechanisms and Enable Rapid Classification between Cardioembolic and Atherosclerosis Etiologies

Electrochemical impedimetric detection of stroke biomarker NT-proBNP using disposable screen-printed gold electrodes

Contact Info

Product

Resources

About