| Midregional pro-atrial natriuretic peptide and outcome in patients with acute ischemic stroke. | |
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MedLine Citation:
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PMID: 20846604 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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). |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2010-09-17 Completed Date: 2010-10-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1045-53 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Endocrinology, University Hospital Basel, Basel, Switzerland. katanm@uhbs.ch |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00390962 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Biological Markers; 0/midregional pro-atrial natriuretic peptide, human; 85637-73-6/Atrial Natriuretic Factor |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Sep 21;56(13):1054-5
[PMID:
20846605
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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