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Independent Prognostic Value of MRproANP (Midregional Proatrial Natriuretic Peptide) Levels in Patients With Stroke Is Unaltered Over Time


Arnold, Markus; Nakas, Christos; Luft, Andreas; Christ-Crain, Mirjam; Leichtle, Alexander; Katan, Mira (2020). Independent Prognostic Value of MRproANP (Midregional Proatrial Natriuretic Peptide) Levels in Patients With Stroke Is Unaltered Over Time. Stroke, 51(6):1873-1875.

Abstract

Background and Purpose- MRproANP (midregional proatrial natriuretic peptide) is known to be independently associated with cardioembolic stroke cause and to improve risk stratification for 90-day mortality when measured within 24 to 72 hours after symptom onset in patients with acute ischemic stroke. However, the optimal time point for assessment remains unclear. This study aimed to evaluate prognostic utility of MRproANP at different time points during the first 5 days of hospitalization in patients with acute ischemic stroke. Methods- Samples of MRproANP were collected on admission (<72 hours after onset) and at multiple time points during the first 5 days of hospitalization in 348 consecutively enrolled patients with acute ischemic stroke. The prognostic value for 90-day mortality, 90-day functional outcome, and the association with cardioembolic stroke cause was assessed regarding the time of measurement, and change over time was modeled using generalized estimating equations. Results- MRproANP levels modestly decease over the initial 5 days but remain highly predictive for cardioembolic stroke cause (odds ratio, 9.75 [95% CI, 3.2-29]; 10.62 [95% CI, 3.4-33.3]; 10.8 [95% CI, 3.1-37.1]; 19.4 [95% CI, 5.49-68.7] on admission, day 1, 3 and 5) and 90-day mortality (odds ratio, 59.4 [95% CI, 7.4-480.7]; 78.3 [95% CI, 7.9-772.6]; 14.5 [95% CI, 1.4-145]; 19.81 [95% CI, 2.7-143.4] on admission, day 1, 3, and 5). Change over time does not significantly modify the prognostic value of MRproANP (P=0.65 and P=0.56 for the interaction term in the multivariate model). Conclusions- Independent prognostic value of MRproANP remains unaltered in the acute phase of stroke at least up to 5 days; repeated measurements do not improve the prognostic value.

Abstract

Background and Purpose- MRproANP (midregional proatrial natriuretic peptide) is known to be independently associated with cardioembolic stroke cause and to improve risk stratification for 90-day mortality when measured within 24 to 72 hours after symptom onset in patients with acute ischemic stroke. However, the optimal time point for assessment remains unclear. This study aimed to evaluate prognostic utility of MRproANP at different time points during the first 5 days of hospitalization in patients with acute ischemic stroke. Methods- Samples of MRproANP were collected on admission (<72 hours after onset) and at multiple time points during the first 5 days of hospitalization in 348 consecutively enrolled patients with acute ischemic stroke. The prognostic value for 90-day mortality, 90-day functional outcome, and the association with cardioembolic stroke cause was assessed regarding the time of measurement, and change over time was modeled using generalized estimating equations. Results- MRproANP levels modestly decease over the initial 5 days but remain highly predictive for cardioembolic stroke cause (odds ratio, 9.75 [95% CI, 3.2-29]; 10.62 [95% CI, 3.4-33.3]; 10.8 [95% CI, 3.1-37.1]; 19.4 [95% CI, 5.49-68.7] on admission, day 1, 3 and 5) and 90-day mortality (odds ratio, 59.4 [95% CI, 7.4-480.7]; 78.3 [95% CI, 7.9-772.6]; 14.5 [95% CI, 1.4-145]; 19.81 [95% CI, 2.7-143.4] on admission, day 1, 3, and 5). Change over time does not significantly modify the prognostic value of MRproANP (P=0.65 and P=0.56 for the interaction term in the multivariate model). Conclusions- Independent prognostic value of MRproANP remains unaltered in the acute phase of stroke at least up to 5 days; repeated measurements do not improve the prognostic value.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Neurology (clinical)
Health Sciences > Cardiology and Cardiovascular Medicine
Health Sciences > Advanced and Specialized Nursing
Language:English
Date:June 2020
Deposited On:11 Jan 2021 06:51
Last Modified:27 Jan 2022 03:00
Publisher:American Heart Association
ISSN:0039-2499
Additional Information:The accepted version is an un-copyedited author manuscript that was accepted for publication in (STROKE, copyright The American Heart Association. This may not be duplicated or reproduced, other than for personal use or within the Fair Use of Copyrighted Materials (section 107, title 17, U.S. Code) without prior permission of the copyright owner, The American Heart Association. The final copyedited article, which is the version of record, can be found at 10.1161/STROKEAHA.120.029333. The American Heart Association disclaims any responsibility or liability for errors or omissions in this version of the manuscript or in any version derived from it by the National Institutes of Health or other parties.
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1161/STROKEAHA.120.029333
PubMed ID:32216532

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