Document Detail


Midregional pro-atrial natriuretic peptide and outcome in patients with acute ischemic stroke.
MedLine Citation:
PMID:  20846604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to examine the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) in patients with acute ischemic stroke. BACKGROUND: The rapid and reliable estimation of prognosis in acute ischemic stroke is pivotal to optimize clinical care. MR-proANP, a recently described, stable fragment of the ANP precursor hormone, may be useful in this setting. METHODS: In a prospective observational study, we measured MR-proANP on admission in plasma of 362 consecutive patients presenting with acute ischemic stroke. The prognostic value of MR-proANP to predict mortality within 90 days and functional outcome (defined as a modified Rankin Scale of ≤2 or ≥3) was evaluated and compared with the National Institutes of Health Stroke Scale (NIHSS) score. RESULTS: The discriminatory accuracy, calculated with the area under the curve (AUC) of the receiver operating characteristics curve, of MR-proANP to predict death was comparable to the NIHSS (AUC: 0.86 [95% confidence interval (CI): 0.82 to 0.90] and 0.85 [95% CI: 0.81 to 0.89; p = 0.7]). Combined, the accuracy significantly improved (0.92 [95% CI: 0.88 to 0.96; p < 0.01]). The AUC of MR-proANP to predict functional outcome was 0.70 (95% CI: 0.65 to 0.75), similar to the NIHSS (0.75 [95% CI: 0.70 to 0.80]; p = 0.16). The prognostic value of MR-proANP for both outcomes was independent of the NIHSS. Higher MR-proANP concentrations were found in stroke of cardioembolic etiology. CONCLUSIONS: MR-proANP is a prognostic marker in the acute phase of stroke, improving the discriminatory value of the NIHSS, independently predicting post-stroke mortality and functional outcome. (The "COSMOS"-Study [Copeptin in Osmoregulation and Stress Assessment]; NCT00390962).
Authors:
Mira Katan; Felix Fluri; Philipp Schuetz; Nils G Morgenthaler; Christian Zweifel; Roland Bingisser; Ludwig Kappos; Andreas Steck; Stefan T Engelter; Beat Müller; Mirjam Christ-Crain
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1045-53     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Endocrinology, University Hospital Basel, Basel, Switzerland. katanm@uhbs.ch
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00390962
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrial Natriuretic Factor / blood*
Biological Markers
Brain Ischemia
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Predictive Value of Tests
Prognosis
Prospective Studies
Stroke / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/midregional pro-atrial natriuretic peptide, human; 85637-73-6/Atrial Natriuretic Factor
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 Sep 21;56(13):1054-5   [PMID:  20846605 ]

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