Abstract Details

Title N-Terminal Probrain Natriuretic Peptide as a marker for diagnosis of Cardioembolic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-050

Objective To estimate N-Terminal probrain natriuretic peptide levels in different subtypes and its usefulness as a diagnostic marker for cardioembolic stroke.

Background Cardioembolic strokes are the subtype of infarcts with the highest in-hospital mortality during the acute phase. Arrhythmias may be missed by routine ECG and conventional 24 hour Holter monitoring. An elevated NT-proBNP may hint at a possible underlying cardiogenic source, thereby prompting further cardiac evaluation and initiating anticoagulation for secondary stroke prevention.

Design/Methods 150 consecutive patients of acute ischemic stroke presenting to Sir Ganga Ram Hospital were included over a study duration of 18 months (July 2016 to December 2017). Patients were subjected to clinical data collection, general and neurological examination, laboratory assessment, cardiac assessment, brain and carotid imaging. The patients were classified according to Trial of ORG 10172 in acute stroke treatment (TOAST) classification. Sample for NT-proBNP was sent in all these patients on admission, within 72 hours of symptom onset and the data was analyzed.

Results

Mean age of patients was 62.37 years with 31% females. Cardioembolic stroke was the most frequent subtype present in 28% of patients. In logistic regression analysis, NT-proBNP was found to be significantly associated with age (p=0.001), NIHSS score (p=0.005), previous cardiac history (p=0.016) and left atrium size (p=0.013). NT-proBNP levels were significantly elevated in cardioembolic stroke (p<0.0001). The area under the receiver operating characteristic curve for NT-proBNP in cardioembolic stroke was 0.935 (standard error 0.019; 95% confidence interval 0.897-0.972), and the optimum cutoff point, sensitivity, and specificity were 400pg/mL, 88.1%, and 80.56% respectively.

Conclusions

NT-proBNP has an acceptable diagnostic value in distinguishing cardioembolic stroke from other subtypes. It can be used to differentiate the stroke subtype and facilitate appropriate treatment process in patients, hence reducing the rate of recurrent stroke.

Authors/Disclosures
Virti D. Shah, Sr., MD, MBBS (Sir Ganga Ram Hospital) PRESENTER	No disclosure on file
Anshu Rohatgi, MD, DM, FAAN	No disclosure on file
Chandrashekhar Agrawal, MD (NICHOLAS PIRAMAL INDIA LIMITED)	No disclosure on file
Rajeeev Ranjan	No disclosure on file
	No disclosure on file
Yatin Sagvekar	No disclosure on file

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