B-type natriuretic peptides and mortality after stroke A systematic review and meta-analysis

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dc.contributor.authorBerrocoso, Teresa Garcia
dc.contributor.authorGiralt, Dolors
dc.contributor.authorBustamante, Alejandro
dc.contributor.authorEtgen, Thorleif
dc.contributor.authorJensen, Jesper K.
dc.contributor.authorSharma, Jagdish C.
dc.contributor.authorMontaner, Joan
dc.date.accessioned2020-04-30T22:40:23Z
dc.date.available2020-04-30T22:40:23Z
dc.date.issued2013
dc.departmentDÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.descriptionSaritas, Ayhan/0000-0002-4302-1093; Montaner, Joan/0000-0003-4845-2279; Saritas, Ayhan/0000-0002-4302-1093; GARCIA-BERROCOSO, TERESA/0000-0001-8072-8533; Whiteley, William/0000-0002-4816-8991; Khedri Jensen, Jesper/0000-0001-7426-4437en_US
dc.descriptionWOS: 000330771700007en_US
dc.descriptionPubMed: 24186915en_US
dc.description.abstractObjective: To measure the association of B-type natriuretic peptide (BNP) and N-terminal fragment of BNP (NT-proBNP) with all-cause mortality after stroke, and to evaluate the additional predictive value of BNP/NT-proBNP over clinical information. Methods: Suitable studies for meta-analysis were found by searching MEDLINE and EMBASE databases until October 26, 2012. Weighted mean differences measured effect size; meta-regression and publication bias were assessed. Individual participant data were used to estimate effects by logistic regression and to evaluate BNP/NT-proBNP additional predictive value by area under the receiver operating characteristic curves, and integrated discrimination improvement and categorical net reclassification improvement indexes. Results: Literature-based meta-analysis included 3,498 stroke patients from 16 studies and revealed that BNP/NT-proBNP levels were 255.78 pg/mL (95% confidence interval [CI] 105.10-406.47, p = 0.001) higher in patients who died; publication bias entailed the loss of this association. Individual participant data analysis comprised 2,258 stroke patients. After normalization of the data, patients in the highest quartile had double the risk of death after adjustment for clinical variables (NIH Stroke Scale score, age, sex) (odds ratio 2.30, 95% CI 1.32-4.01 for BNP; and odds ratio 2.63, 95% CI 1.75-3.94 for NT-proBNP). Only NT-proBNP showed a slight added value to clinical prognostic variables, increasing discrimination by 0.028 points (integrated discrimination improvement index; p < 0.001) and reclassifying 8.1% of patients into correct risk mortality categories (net reclassification improvement index; p = 0.003). Neither etiology nor time from onset to death affected the association of BNP/NT-proBNP with mortality. Conclusion: BNPs are associated with poststroke mortality independent of NIH Stroke Scale score, age, and sex. However, their translation to clinical practice seems difficult because BNP/NT-proBNP add only minor predictive value to clinical information.en_US
dc.description.sponsorshipInstituto de Salud Carlos IIIInstituto de Salud Carlos III [FI09/00017]; FIS [11/0176]; Chief Scientist's Office [CAF/06/30]; UK Medical Research Council Clinician Scientist FellowshipMedical Research Council UK (MRC) [G0902303]; Medical Research CouncilMedical Research Council UK (MRC) [G0902303]; Chief Scientist Office [CAF/06/30]en_US
dc.description.sponsorshipT. Garcia-Berrocoso is supported by a predoctoral fellowship (FI09/00017) from the Instituto de Salud Carlos III. Neurovascular Research Laboratory takes part in the Spanish stroke research network INVICTUS (RD12/0014/0005) and is supported on stroke biomarkers research by FIS 11/0176. D. Giralt, A. Bustamante, T. Etgen, J. Jensen, J. Sharma, K. Shibazaki, A. Saritas, and X. Chen report no disclosures. W. Whiteley was supported by the Chief Scientist's Office (CAF/06/30) and is now funded by a UK Medical Research Council Clinician Scientist Fellowship (G0902303). J. Montaner reports no disclosures. Go to Neurology.org for full disclosures.en_US
dc.identifier.doi10.1212/01.wnl.0000436937.32410.32en_US
dc.identifier.endpage1985en_US
dc.identifier.issn0028-3878
dc.identifier.issn1526-632X
dc.identifier.issue23en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1976en_US
dc.identifier.urihttps://doi.org/10.1212/01.wnl.0000436937.32410.32
dc.identifier.urihttps://hdl.handle.net/20.500.12684/2972
dc.identifier.volume81en_US
dc.identifier.wosWOS:000330771700007en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofNeurologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleB-type natriuretic peptides and mortality after stroke A systematic review and meta-analysisen_US
dc.typeArticleen_US

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