Ran Liu,1 Guojuan Chen,2 Na Zhao,1 Wei Yue1 

1Department of Neurology, Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin Huanhu Hospital, Tianjin, 300350, People’s Republic of China; 2Department of Neurology, Tangshan Gongren Hospital, Tangshan, People’s Republic of China

Correspondence: Wei Yue, Department of Neurology, Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin Huanhu Hospital, No. 6 Jizhao Road, Shuanggang Town, Jinnan District, Tianjin, 300350, People’s Republic of China, Email hhyuewei2021@163.com

Purpose: Our study aimed to evaluate the prognostic value of NT-proBNP in predicting adverse outcomes among patients with anterior circulation infarction (ACI) and posterior circulation infarction (PCI), specifically in those without pre-existing cardiac comorbidities.
Patients and Methods: This single-center, prospective observational study enrolled patients with acute ischemic stroke (AIS) within 7 days of symptom onset. We aimed to elucidate predictive role of NT-proBNP levels in determining adverse outcomes in AIS patients. Additionally, the study sought to explore the relationship between NT-proBNP levels and the risk of poor functional outcomes in both ACI and PCI patients without underlying cardiac comorbidities.
Results: A total of 821 patients were included in our study. Both univariate and multivariate logistic analyses indicated that higher NT-proBNP was an independent risk factor for adverse outcomes of ischemic stroke patients at 90 days. In noncardiogenic patients, the risks of adverse outcomes during follow-up were significantly elevated in the medium and high NT-proBNP groups (medium group: OR 1.75, 95% CI 1.03– 2.98, P=0.039; high group: OR 2.46, 95% CI 1.30– 4.67, P=0.006), with a dose-dependent trend. The association was similarly observed in patients with isolated ACI (medium group: OR 2.02, 95% CI 1.06– 3.83, P=0.031; high group: OR 2.70, 95% CI 1.25– 5.79, P=0.011). High NT-proBNP levels were independently associated with END in patients without underlying cardiac comorbidities (high group: OR 2.14, 95% CI 1.06– 4.31, P=0.033) and this association was also observed in ACI patients (high group: OR 5.39, 95% CI 1.70– 17.04, P=0.004). Moreover, when incorporated into the clinical prediction model, NT-proBNP exhibited excellent sensitivity and specificity for predicting stroke-related functional outcomes.
Conclusion: NT-proBNP demonstrates potential as a valuable biomarker in the clinical predictive model for functional outcomes specifically in ACI patients suggesting that elevated NT-proBNP levels in these patients should prompt closer monitoring and more comprehensive patient management.
Trial Registration: https://www.chictr.org.cn/, ChiCTR2300067696.

Keywords: NT-proBNP, anterior circulation infarction, posterior circulation infarction, functional outcomes