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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Jenny, Nancy S. Thacker, Evan L. Zakai, Neil A. Kissela, Brett Gutiérrez, Orlando M. Judd, Suzanne E. Ahmed, Ali Cushman, Mary Howard, Virginia J. |
| Description | Author Affiliation: Cushman M ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Judd SE ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Howard VJ ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Kissela B ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Gutiérrez OM ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Jenny NS ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Ahmed A ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Thacker EL ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)); Zakai NA ( From the Departments of Medicine and Pathology, University of Vermont, Colchester (M.C., N.S.J., N.A.Z.)) |
| Abstract | BACKGROUND AND PURPOSE: Improved identification of those at risk of stroke might improve prevention. We evaluated the association of the cardiac function biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) with stroke risk in the 30 239 black and white participants of the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. METHODS: During 5.4 years of follow-up after enrollment in 2003 to 2007, NT-proBNP was measured in baseline blood samples of 546 subjects with incident ischemic stroke and 956 without stroke. RESULTS: NT-proBNP was higher with older age and in those with heart disease, kidney disease, atrial fibrillation, and lower low-density lipoprotein-cholesterol. Adjusting for age, race, sex, income, education, and traditional stroke risk factors, there was an increased risk of stroke across quartiles of NT-proBNP; participants with NT-proBNP in the top versus the bottom quartile had a hazard ratio of 2.9 (95% confidence interval, 1.9-4.5). There was no impact of added adjustment for kidney function and heart failure. Among pathogenetic stroke subtypes, the association was largest for cardioembolic stroke, with a hazard ratio of 9.1 (95% confidence interval, 2.9-29.2). Associations did not differ by age, sex, or race, or after excluding those with baseline heart failure or atrial fibrillation. Predicted stroke risk was more accurate in 27% of participants if NT-proBNP was considered after traditional stroke risk factors (P<0.001). CONCLUSIONS: NT-proBNP was a major independent risk marker for stroke. Considering this and other data for stroke, coronary disease, and atrial fibrillation, the clinical use of NT-proBNP measurement in primary prevention settings should be considered. |
| ISSN | 00392499 |
| e-ISSN | 15244628 |
| DOI | 10.1161/STROKEAHA.114.004712 |
| Journal | Stroke |
| Issue Number | 6 |
| Volume Number | 45 |
| Language | English |
| Publisher | Lippincott Williams & Wilkins (on behalf of the American Heart Association) |
| Publisher Date | 2014-06-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Continental Population Groups Natriuretic Peptide, Brain Blood Peptide Fragments Stroke Atrial Fibrillation Epidemiology Ethnology Biological Markers Coronary Artery Disease Heart Failure Retrospective Studies Sex Factors Clinical Trial Multicenter Study Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Discipline Cardiology |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical) |
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