Heart failure may be associated with the onset of ischemic stroke with atrial fibrillation: A brain natriuretic peptide study

Abstract

Background and purpose Congestive heart failure is a risk factor for ischemic stroke. Brain natriuretic peptide (BNP) is used as a biological marker of heart failure. We hypothesized that heart failure was associated with the onset of ischemic stroke patients with atrial fibrillation (AF). Methods Between June 2006 and December 2007, we prospectively enrolled consecutive acute ischemic stroke patients with AF within 24 h of onset. Plasma BNP was measured twice, on admission and on days 28 or at discharge. As a control, we measured plasma BNP of chronic phase of stroke outpatients with AF. We investigated whether plasma BNP was elevated in the acute phase of stroke. Results One hundred and nine patients (58 females; mean age, 76.3 years) were enrolled in the present study. Mean ± SD of NIHSS score on admission and mRS score at discharge were 12.6 ± 8.3 and 3.7 ± 1.8, respectively. The interval from stroke onset to plasma BNP measurement on admission was 6.8 ± 6.3 h. Moreover, follow up BNP was measured at mean of 26 ± 9 days after stroke onset. The plasma BNP level in the acute phase of stroke was significantly higher than that of the subacute phase of stroke (median (interquartile range, IQR) 299.0 (176.8–469.5) vs. 149.5 (68.1–347.0) pg/ml, p < 0.001). There was no significant difference in plasma BNP level between the subacute phase of stroke and control group (median (IQR) 149.5 (68.1–347.0) vs. 165.0 (64.6–224.0) pg/ml, p = 0.543). Conclusion Plasma BNP was elevated in the acute phase of stroke. Heart failure may be associated with the onset of ischemic stroke patients with AF.