The Utility of Plasma N- Terminal Brain Natriuretic peptide (NT- Pro BNP) as a Biomarker to Differentiate Cardio embolic Stroke from Non-Cardio embolic Stroke.

Abstract

TITLE: The Utility of Plasma N- Terminal Brain Natriuretic Peptide (NT- Pro BNP) as a Biomarker to Differentiate Cardio embolic Stroke from Non-Cardio embolic Stroke. PURPOSE: To measure plasma NT-Pro BNP in patients with acute ischemic stroke and investigate whether the plasma NT- pro BNP level can be a useful bio marker to differentiate cardio embolic (CE) stroke from non-cardio embolic (NCE) stroke or not. STUDY DESIGN: In our analytic observational prospective study, 66 patients were enrolled within 24 hours of the onset of acute ischemic stroke and met inclusion and exclusion criteria. METHODOLOGY: Plasma NT-pro BNP level was performed in each patient. Clinical observations were recorded on special performa designed for the study. They were classified in to four groups: Cardioembolic (CE), Large artery atherosclerosis (LAA), Small-vessel disease (SVD) and other subtypes according to TOAST classification. Study outcome was measured by applying appropriate statistical tests at the end of all patient enrolments. RESULTS: Out of 66 patients, 21(31.81 %) were cardioembolic whereas 45 (68.18%) patients were in non-cardioembolic (NCE) group. The result showed that plasma NT pro BNP levels were significantly higher in CE group than NCE group (p value<0.001). The optimal cut off point for NT pro BNP levels to differentiate CE stroke from NCE stroke was > 594 pg./ml with 93.33% Specificity and 66.67% Sensitivity. CONCLUSION: As plasma biomarker NT-pro BNP has a good sensitivity, specificity and accuracy for early identification of cardio embolic stroke.