Correlation Between NT-proBNP And Etiology,Severity And Prognosis Of Acute Cerebral Infarction

Objective:N-terminal pro-brain natriuretic peptide(NT-pro BNP)is a sensitive marker for cardiac function.In recent years,there have been studies on the use of blood NT-pro BNP for etiological diagnosis and assessment of acute cerebral infarction(ACI),achieving certain results.However,the application of NT-pro BNP in ACI is still at an early stage.Therefore,this study aims to provide a basis for secondary prevention of ACI through analyzing the correlation between NT-pro BNP and etiology,severity and prognosis of ACI.Methods:Between January 2017 and April 2019,80 patients with ACI(ACI group)and 40 healthy volunteers(control group)were enrolled in this study.The blood NT-pro BNP levels in the control group and ACI group(24h ～ 48 h after onset)were detected,and the trial of org10172 in acute stroke treatment(TOAST)etiological classification data of ACI group were recorded.The severity of neurological deficits at 14 days after admission was evaluated with the National Institutes of Health Stroke Scale(NIHSS)and the prognosis at3 months after admission was assessed with the modified Rinkin scale(m RS).The relationship between blood NT-pro BNP levels and etiology,severity of neurological deficits,prognosis and other data(previous history,underlying disease,heart disease,results of cardiac ultrasound examination)was analyzed by multiple linear regression analysis,and the scatter plot was used for correlation analysis.Meanwhile,the receiver operating characteristic(ROC)curves were used to analyze the value of blood NT-pro BNP in etiological diagnosis,neurological deficit evaluation and prognosis of patients.Results:(1)The blood NT-pro BNP levels were higher in ACI group than in the control group,significantly higher in patients with TOAST cardioembolism(CE)type ACI than in those with non-CE ACI,higher in ACI patients with NIHSS score ≥ 7 than in those with 0 ～ 6,higher in patients with m RS score ≥ 3 than in those with m RS score < 3,and significantly higher in ACI patients with thickened ventricular septum than in those with normal ventricular septum(P<0.05).(2)Cardiogenic infarction,severity of neurological deficits,and m RS score at 3months after admission were all influencing factors of NT-pro BNP level,namely,there was a significant correlation between NT-pro BNP and cardiogenic infarction,severity of neurological deficits as well as the m RS score at 3 months after admission(P<0.05).(3)The area under the curve(AUC)value of blood NT-pro BNP for identifying the cause of ACI(CE type)was 0.991.With a cut-off value of 399.3ng/L,the sensitivity and specificity for identifying CE type ACI were 94.44% and 96.77%.Using >294.42ng/L and>585.54ng/L as the critical values,the sensitivity of blood NT-pro BNP for predicting the degree of neurological deficits and prognosis of ACI patients was 72.22% and 44.44%,and the specificity was 79.55% and 98.08%.Conclusion:Compared with normal healthy people,patients with ACI have significantly elevated blood NT-pro BNP levels in 24h～48h after onset.Besides,the blood NT-pro BNP level is closely related to cardiogenic infarction,the severity of neurological deficits,and the m RS score at 3 months after admission,suggesting that it can be used as a sensitive indicator for identifying CE type ACI and predicting the severity of neurological deficit and prognosis.