Generic placeholder image

Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

Higher NT-proBNP Levels are Related to Poor Functional Outcome and Pneumonia in Acute Intracerebral Hemorrhage Patients

Author(s): Xinjia Pan, Huan Wu, Yi Zhou, Liyan Song, Wanqing Zhai, Shoujiang You*, Weidong Hu* and Yongjun Cao

Volume 19, Issue 4, 2022

Published on: 17 November, 2022

Page: [391 - 397] Pages: 7

DOI: 10.2174/1567202620666221020150724

Price: $65

conference banner
Abstract

Background: We investigated the association between N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) levels upon hospital admission and early hematoma growth (HG), inhospital pneumonia and major disability in patients with acute intracerebral hemorrhage (ICH).

Methods: A total of 353 ICH patients from January 2014 to February 2019 were included in the present study. Patients were divided into three groups based on the admission NT-proBNP levels (T1: <61; T2: 61-199; T3: ≥199 pg/mL). Logistic regression models were used to estimate the effect of NT-proBNP on early HG, in-hospital pneumonia, and major disability upon hospital discharge (modified Rankin Scale score ≥5) in ICH patients.

Results: There was no significant association observed between baseline NT-proBNP levels and early HG (P-trend =0.249). The risk of in-hospital pneumonia was significantly higher in patients with the highest NT-proBNP level (T3) (adjusted odds ratio [OR] 2.13; 95% confidence interval [CI], 1.11-4.08) and higher NT-proBNP level (T2) (adjusted OR 2.18; 95% CI, 1.19-4.00) compared to those with lowest NT-proBNP level (T1). The highest NT-proBNP level (T3) was associated with a 3.55-fold increase in the risk of major disability at hospital discharge (adjusted OR 3.55; 95% CI, 1.23-10.26; P-trend =0.013) in comparison to T1 after adjustment for potential covariates, including pneumonia.

Conclusion: Increased NT-proBNP at admission was independently associated with in-hospital pneumonia and major disability upon discharge but not early hematoma growth in acute ICH patients.

[1]
Chen Y, Wright N, Guo Y, et al. Mortality and recurrent vascular events after first incident stroke: A 9-year community-based study of 0·5 million Chinese adults. Lancet Glob Health 2020; 8(4): e580-90.
[http://dx.doi.org/10.1016/S2214-109X(20)30069-3] [PMID: 32199124]
[2]
Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review. Lancet Neurol 2009; 8(4): 355-69.
[http://dx.doi.org/10.1016/S1474-4422(09)70025-0] [PMID: 19233729]
[3]
Badve MS, Zhou Z, van de Beek D, Anderson CS, Hackett ML. Frequency of post-stroke pneumonia: Systematic review and meta-analysis of observational studies. Int J Stroke 2019; 14(2): 125-36.
[http://dx.doi.org/10.1177/1747493018806196] [PMID: 30346258]
[4]
Dowlatshahi D, Demchuk AM, Flaherty ML, Ali M, Lyden PL, Smith EE. Defining hematoma expansion in intracerebral hemorrhage: Relationship with patient outcomes. Neurology 2011; 76(14): 1238-44.
[http://dx.doi.org/10.1212/WNL.0b013e3182143317] [PMID: 21346218]
[5]
Wang TJ. The natriuretic peptides and fat metabolism. N Engl J Med 2012; 367(4): 377-8.
[http://dx.doi.org/10.1056/NEJMcibr1204796] [PMID: 22830469]
[6]
Epstein FH, Levin ER, Gardner DG, Samson WK. Natriuretic peptides. N Engl J Med 1998; 339(5): 321-8.
[http://dx.doi.org/10.1056/NEJM199807303390507] [PMID: 9682046]
[7]
Mäkikallio AM, Mäkikallio TH, Korpelainen JT, et al. Natriuretic peptides and mortality after stroke. Stroke 2005; 36(5): 1016-20.
[http://dx.doi.org/10.1161/01.STR.0000162751.54349.ae] [PMID: 15802631]
[8]
Wang A, Zhang M, Ding Y, et al. Associations of B‐Type natriuretic peptide and its coding gene promoter methylation with functional outcome of acute ischemic stroke: A mediation analysis. J Am Heart Assoc 2020; 9(18): e017499.
[http://dx.doi.org/10.1161/JAHA.120.017499] [PMID: 32875935]
[9]
Pan H, Feng K, Fu M, Ge W, Zhou C. Correlation between the B-type natriuretic peptide before thrombolysis and prognosis in patients with ischemic stroke. Clin Neurol Neurosurg 2021; 211: 107021.
[http://dx.doi.org/10.1016/j.clineuro.2021.107021] [PMID: 34808477]
[10]
Shibazaki K, Kimura K, Okada Y, et al. Plasma brain natriuretic peptide as an independent predictor of in hospital mortality after acute ischemic stroke. Intern Med 2009; 48(18): 1601-6.
[http://dx.doi.org/10.2169/internalmedicine.48.2166] [PMID: 19755761]
[11]
Whiteley W, Wardlaw J, Dennis M, et al. The use of blood biomarkers to predict poor outcome after acute transient ischemic attack or ischemic stroke. Stroke 2012; 43(1): 86-91.
[http://dx.doi.org/10.1161/STROKEAHA.111.634089] [PMID: 22020034]
[12]
Duello KM, Nagel JP, Blackshear JL, Freeman WD, Montaner J, Garcia-Berrocoso T. B-type natriuretic peptides and mortality after stroke: A systematic review and meta-analysis. Neurology 2014; 83(3): 292-3.
[http://dx.doi.org/10.1212/WNL.0000000000000634] [PMID: 25024445]
[13]
Wang J, Wang J, Tang Z, Zhang P. Association of natriuretic peptide with adverse outcomes and disease severity after intracerebral hemorrhage: A systematic review. Front Neurol 2021; 12: 775085.
[http://dx.doi.org/10.3389/fneur.2021.775085] [PMID: 34867764]
[14]
Gregorio T, Albuquerque I, Neves V, et al. NT-pro-BNP correlates with disease severity and predicts outcome in cerebral haemorrhage patients: Cohort study. J Neurol Sci 2019; 399: 51-6.
[http://dx.doi.org/10.1016/j.jns.2019.02.014] [PMID: 30772761]
[15]
Goya Y, Shibazaki K, Sakai K, et al. Brain natriuretic peptide upon admission as a biological marker of short term mortality after intracerebral hemorrhage. Eur Neurol 2014; 71(3-4): 203-7.
[http://dx.doi.org/10.1159/000356198] [PMID: 24457596]
[16]
Rudiger A, Fischler M, Harpes P, et al. In critically ill patients, B-type natriuretic peptide (BNP) and N-terminal pro-BNP levels correlate with C-reactive protein values and leukocyte counts. Int J Cardiol 2008; 126(1): 28-31.
[http://dx.doi.org/10.1016/j.ijcard.2007.03.108] [PMID: 17477984]
[17]
George J, Mackle G, Manoharan A, Khan F, Struthers AD. High BNP levels in rheumatoid arthritis are related to inflammation but not to left ventricular abnormalities: A prospective case-control study. Int J Cardiol 2014; 172(1): e116-8.
[http://dx.doi.org/10.1016/j.ijcard.2013.12.119] [PMID: 24433615]
[18]
Mueller C, Laule-Kilian K, Scholer A, Perruchoud AP. B-type natriuretic peptide for risk stratification in community acquired pneumonia. J Intern Med 2005; 258(4): 391-3.
[http://dx.doi.org/10.1111/j.1365-2796.2005.01540.x] [PMID: 16164581]
[19]
Kothari RU, Brott T, Broderick JP, et al. The ABCs of measuring intracerebral hemorrhage volumes. Stroke 1996; 27(8): 1304-5.
[http://dx.doi.org/10.1161/01.STR.27.8.1304] [PMID: 8711791]
[20]
Yangco B. CDC definitions for nosocomial infections. Am J Infect Control 1989; 17(1): 42-3.
[http://dx.doi.org/10.1016/S0196-6553(89)80013-6] [PMID: 2538096]
[21]
Erdur H, Scheitz JF, Grittner U, Laufs U, Endres M, Nolte CH. Heart rate on admission independently predicts in-hospital mortality in acute ischemic stroke patients. Int J Cardiol 2014; 176(1): 206-10.
[http://dx.doi.org/10.1016/j.ijcard.2014.07.001] [PMID: 25049007]
[22]
Hodges M, Bailey JJ, Church TR. B-type natriuretic peptide predicts sudden death in patients with chronic heart failure. Circulation 2003; 107(1): e13.
[http://dx.doi.org/10.1161/01.CIR.0000046777.74753.F8] [PMID: 12515766]
[23]
de Lemos JA, Morrow DA, Bentley JH, et al. The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes. N Engl J Med 2001; 345(14): 1014-21.
[http://dx.doi.org/10.1056/NEJMoa011053] [PMID: 11586953]
[24]
Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med 2004; 350(7): 655-63.
[http://dx.doi.org/10.1056/NEJMoa031994] [PMID: 14960742]
[25]
Li F, Chen QX, Xiang SG, Yuan SZ, Xu XZ. The role of N-terminal pro-brain natriuretic peptide in evaluating the prognosis of patients with intracerebral hemorrhage. J Neurol 2017; 264(10): 2081-7.
[http://dx.doi.org/10.1007/s00415-017-8602-0] [PMID: 28840579]
[26]
Stanciu AE, Stanciu MM, Vatasescu RG. NT-proBNP and CA 125 levels are associated with increased pro-inflammatory cytokines in coronary sinus serum of patients with chronic heart failure. Cytokine 2018; 111: 13-9.
[http://dx.doi.org/10.1016/j.cyto.2018.07.037] [PMID: 30098475]
[27]
Patel UK, Kodumuri N, Dave M, et al. Stroke associated pneumonia. Neurologist 2020; 25(3): 39-48.
[http://dx.doi.org/10.1097/NRL.0000000000000269] [PMID: 32358460]
[28]
Palumbo V, Baldasseroni S, Nencini P, et al. The coexistence of heart failure predicts short term mortality, but not disability, in patients with acute ischemic stroke treated with thrombolysis: The florence area registry. Eur J Intern Med 2012; 23(6): 552-7.
[http://dx.doi.org/10.1016/j.ejim.2012.03.015] [PMID: 22863434]
[29]
Shima S, Shinoda M, Takahashi O, et al. Risk Factors for acute heart failure and impact on in-hospital mortality after stroke. J Stroke Cerebrovasc Dis 2019; 28(6): 1629-35.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.02.030] [PMID: 30930241]
[30]
Xue M, Yong VW. Neuroinflammation in intracerebral haemorrhage: immunotherapies with potential for translation. Lancet Neurol 2020; 19(12): 1023-32.
[http://dx.doi.org/10.1016/S1474-4422(20)30364-1] [PMID: 33212054]
[31]
Bai Q, Xue M, Yong VW. Microglia and macrophage phenotypes in intracerebral haemorrhage injury: Therapeutic opportunities. Brain 2020; 143(5): 1297-314.
[http://dx.doi.org/10.1093/brain/awz393] [PMID: 31919518]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy