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  • Greater Serum Concentrations of N-terminal Pro-B-type Natriuretic Peptide, High Sensitivity C-reactive Protein and Inteleukin-6 Predict Poor Outcomes After Stroke

    Final Number:

    Adomas Bunevicius MD PhD; Henrikas Kazlauskas; Nijole Raskauskiene; Narseta Mickuviene; Robertas Bunevicius

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP), high sensitivity C-reactive protein (hsCRP) and inteleukin-6 (IL-6) concentrations were implicated in stroke outcomes. In acute ischemic and hemorrhagic stroke patients we investigated the association of NT-proBNP, hsCRP and IL-6 serum concentrations with stroke severity, and with functional and cognitive outcomes at discharge.

    Methods: Seventy eight patients (53 men; median age 72 years) admitted with ischemic and hemorrhagic stroke within 48-hours of symptom onset were evaluated for clinical stroke severity (Scandinavian Stroke Scale), functional status before stroke (modified Rankin scale) and cerebrovascular disease risk factors. Cognitive (Mini Mental State Examination) and functional (mRS) outcomes were evaluated at hospital discharge. Blood samples were drawn for NT-proBNP, hsCRP and IL-6 concentration assessment within 24-hours of admission.

    Results: . In multivariable adjusted regression models with IL-6, hsCRP and NT-proBNP considered together, IL-6 and hsCRP remained associated with worse functional (ß=0.210; p=0.022) and cognitive (ß=-0.269; p=0.014) outcomes at discharge, respectively. In receiver operating characteristic analyses, the investigated blood biomarkers provided with minimal increase of predictive values for discharge outcome above SSS score, age and gender.

    Conclusions: In acute stroke patients, greater NT-proBNP and hsCRP serum concentration are independently associated with greater clinical stroke severity. Elevated concentrations of IL-6 and hsCRP are associated with worse functional and cognitive discharge outcomes, respectively.

    Patient Care: Assessment of NT-proBNP,hsCRP and IL-6 serum concentrations can improve patient prognostication.

    Learning Objectives: To learn that greater inflammatory marker and NT-proBNP concentrations are associated with poor discharge outcomes in acute cerebrovascular disease patients,


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