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NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke

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NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke. / Di Castelnuovo, Augusto; Veronesi, Giovanni; Costanzo, Simona; Zeller, Tanja; Schnabel, Renate B; de Curtis, Amalia; Salomaa, Veikko; Borchini, Rossana; Ferrario, Marco; Giampaoli, Simona; Kee, Frank; Söderberg, Stefan; Niiranen, Teemu; Kuulasmaa, Kari; de Gaetano, Giovanni; Donati, Maria Benedetta; Blankenberg, Stefan; Iacoviello, Licia; BiomarCaRE Investigators.

In: STROKE, Vol. 50, No. 3, 03.2019, p. 610-617.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Di Castelnuovo, A, Veronesi, G, Costanzo, S, Zeller, T, Schnabel, RB, de Curtis, A, Salomaa, V, Borchini, R, Ferrario, M, Giampaoli, S, Kee, F, Söderberg, S, Niiranen, T, Kuulasmaa, K, de Gaetano, G, Donati, MB, Blankenberg, S, Iacoviello, L & BiomarCaRE Investigators 2019, 'NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke', STROKE, vol. 50, no. 3, pp. 610-617. https://doi.org/10.1161/STROKEAHA.118.023218

APA

Di Castelnuovo, A., Veronesi, G., Costanzo, S., Zeller, T., Schnabel, R. B., de Curtis, A., Salomaa, V., Borchini, R., Ferrario, M., Giampaoli, S., Kee, F., Söderberg, S., Niiranen, T., Kuulasmaa, K., de Gaetano, G., Donati, M. B., Blankenberg, S., Iacoviello, L., & BiomarCaRE Investigators (2019). NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke. STROKE, 50(3), 610-617. https://doi.org/10.1161/STROKEAHA.118.023218

Vancouver

Di Castelnuovo A, Veronesi G, Costanzo S, Zeller T, Schnabel RB, de Curtis A et al. NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke. STROKE. 2019 Mar;50(3):610-617. https://doi.org/10.1161/STROKEAHA.118.023218

Bibtex

@article{e54ec5d1ec8c4ef680420d0df9bcacd9,
title = "NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke",
abstract = "Background and Purpose- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a risk factor for atrial fibrillation and a marker of cardiac function used in the detection of heart failure. Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke and to determine the predictive value beyond a panel of established risk factors. Methods- Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-Consortium, we analyzed data of 58 173 participants (50% men; mean age 52 y) free of stroke from 6 community-based cohorts. NT-proBNP measurements were performed in the central Biomarkers for Cardiovascular Risk Assessment in Europe laboratory. The outcomes considered were total stroke and subtypes of stroke (ischemic/hemorrhagic). Results- During a median follow-up time of 7.9 years, we observed 1550 stroke events (1176 ischemic). Increasing quarters of the NT-proBNP distribution were associated with increasing risk of stroke ( P for trend <0.0001; multivariable Cox regression analysis adjusted for risk factors and cardiac diseases). Individuals in the highest NT-proBNP quarter (NT-proBNP >82.2 pg/mL) had 2-fold (95% CI, 75%-151%) greater risk of stroke than individuals in the lowest quarter (NT-proBNP <20.4 pg/mL). The association remained unchanged when adjusted for interim coronary events during follow-up, and though it was somewhat heterogeneous across cohorts, it was highly homogenous according to cardiovascular risk profile or subtypes of stroke. The addition of NT-proBNP to a reference model increased the C-index discrimination measure by 0.006 ( P=0.0005), yielded a categorical net reclassification improvement of 2.0% in events and 1.4% in nonevents and an integrated discrimination improvement of 0.007. Conclusions- In European individuals free of stroke, levels of NT-proBNP are positively associated with risk of ischemic and hemorrhagic stroke, independently from several other risk factors and conditions. The addition of NT-proBNP to variables of established risk scores improves prediction of stroke, with a medium effect size.",
keywords = "Adult, Atrial Fibrillation/complications, Biomarkers, Brain Ischemia/blood, Cohort Studies, Europe/epidemiology, Female, Humans, Intracranial Hemorrhages/blood, Male, Middle Aged, Natriuretic Peptide, Brain/blood, Peptide Fragments/blood, Predictive Value of Tests, Risk Factors, Sex Factors, Stroke/blood, Treatment Outcome",
author = "{Di Castelnuovo}, Augusto and Giovanni Veronesi and Simona Costanzo and Tanja Zeller and Schnabel, {Renate B} and {de Curtis}, Amalia and Veikko Salomaa and Rossana Borchini and Marco Ferrario and Simona Giampaoli and Frank Kee and Stefan S{\"o}derberg and Teemu Niiranen and Kari Kuulasmaa and {de Gaetano}, Giovanni and Donati, {Maria Benedetta} and Stefan Blankenberg and Licia Iacoviello and {BiomarCaRE Investigators}",
year = "2019",
month = mar,
doi = "10.1161/STROKEAHA.118.023218",
language = "English",
volume = "50",
pages = "610--617",
journal = "STROKE",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

RIS

TY - JOUR

T1 - NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke

AU - Di Castelnuovo, Augusto

AU - Veronesi, Giovanni

AU - Costanzo, Simona

AU - Zeller, Tanja

AU - Schnabel, Renate B

AU - de Curtis, Amalia

AU - Salomaa, Veikko

AU - Borchini, Rossana

AU - Ferrario, Marco

AU - Giampaoli, Simona

AU - Kee, Frank

AU - Söderberg, Stefan

AU - Niiranen, Teemu

AU - Kuulasmaa, Kari

AU - de Gaetano, Giovanni

AU - Donati, Maria Benedetta

AU - Blankenberg, Stefan

AU - Iacoviello, Licia

AU - BiomarCaRE Investigators

PY - 2019/3

Y1 - 2019/3

N2 - Background and Purpose- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a risk factor for atrial fibrillation and a marker of cardiac function used in the detection of heart failure. Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke and to determine the predictive value beyond a panel of established risk factors. Methods- Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-Consortium, we analyzed data of 58 173 participants (50% men; mean age 52 y) free of stroke from 6 community-based cohorts. NT-proBNP measurements were performed in the central Biomarkers for Cardiovascular Risk Assessment in Europe laboratory. The outcomes considered were total stroke and subtypes of stroke (ischemic/hemorrhagic). Results- During a median follow-up time of 7.9 years, we observed 1550 stroke events (1176 ischemic). Increasing quarters of the NT-proBNP distribution were associated with increasing risk of stroke ( P for trend <0.0001; multivariable Cox regression analysis adjusted for risk factors and cardiac diseases). Individuals in the highest NT-proBNP quarter (NT-proBNP >82.2 pg/mL) had 2-fold (95% CI, 75%-151%) greater risk of stroke than individuals in the lowest quarter (NT-proBNP <20.4 pg/mL). The association remained unchanged when adjusted for interim coronary events during follow-up, and though it was somewhat heterogeneous across cohorts, it was highly homogenous according to cardiovascular risk profile or subtypes of stroke. The addition of NT-proBNP to a reference model increased the C-index discrimination measure by 0.006 ( P=0.0005), yielded a categorical net reclassification improvement of 2.0% in events and 1.4% in nonevents and an integrated discrimination improvement of 0.007. Conclusions- In European individuals free of stroke, levels of NT-proBNP are positively associated with risk of ischemic and hemorrhagic stroke, independently from several other risk factors and conditions. The addition of NT-proBNP to variables of established risk scores improves prediction of stroke, with a medium effect size.

AB - Background and Purpose- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a risk factor for atrial fibrillation and a marker of cardiac function used in the detection of heart failure. Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke and to determine the predictive value beyond a panel of established risk factors. Methods- Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-Consortium, we analyzed data of 58 173 participants (50% men; mean age 52 y) free of stroke from 6 community-based cohorts. NT-proBNP measurements were performed in the central Biomarkers for Cardiovascular Risk Assessment in Europe laboratory. The outcomes considered were total stroke and subtypes of stroke (ischemic/hemorrhagic). Results- During a median follow-up time of 7.9 years, we observed 1550 stroke events (1176 ischemic). Increasing quarters of the NT-proBNP distribution were associated with increasing risk of stroke ( P for trend <0.0001; multivariable Cox regression analysis adjusted for risk factors and cardiac diseases). Individuals in the highest NT-proBNP quarter (NT-proBNP >82.2 pg/mL) had 2-fold (95% CI, 75%-151%) greater risk of stroke than individuals in the lowest quarter (NT-proBNP <20.4 pg/mL). The association remained unchanged when adjusted for interim coronary events during follow-up, and though it was somewhat heterogeneous across cohorts, it was highly homogenous according to cardiovascular risk profile or subtypes of stroke. The addition of NT-proBNP to a reference model increased the C-index discrimination measure by 0.006 ( P=0.0005), yielded a categorical net reclassification improvement of 2.0% in events and 1.4% in nonevents and an integrated discrimination improvement of 0.007. Conclusions- In European individuals free of stroke, levels of NT-proBNP are positively associated with risk of ischemic and hemorrhagic stroke, independently from several other risk factors and conditions. The addition of NT-proBNP to variables of established risk scores improves prediction of stroke, with a medium effect size.

KW - Adult

KW - Atrial Fibrillation/complications

KW - Biomarkers

KW - Brain Ischemia/blood

KW - Cohort Studies

KW - Europe/epidemiology

KW - Female

KW - Humans

KW - Intracranial Hemorrhages/blood

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain/blood

KW - Peptide Fragments/blood

KW - Predictive Value of Tests

KW - Risk Factors

KW - Sex Factors

KW - Stroke/blood

KW - Treatment Outcome

U2 - 10.1161/STROKEAHA.118.023218

DO - 10.1161/STROKEAHA.118.023218

M3 - SCORING: Journal article

C2 - 30786848

VL - 50

SP - 610

EP - 617

JO - STROKE

JF - STROKE

SN - 0039-2499

IS - 3

ER -