The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide

Eur J Neurol. 2007 May;14(5):477-82. doi: 10.1111/j.1468-1331.2006.01591.x.

Abstract

Anaemia is a negative prognostic factor for patients with heart failure and impaired renal function, but its role in stroke patients is unknown. Furthermore, anaemia has been shown to influence the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), but this is only investigated in patients with heart failure, not in stroke patients. Two-hundred-and-fifty consecutive, well-defined ischemic stroke patients were investigated. Mortality was recorded at 6 months follow-up. Anaemia was diagnosed in 37 patients (15%) in whom stroke severity was worse than in the non-anaemic group, whilst the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using logistic regression. The median NT-proBNP level in the anaemic group was significantly higher than in the non-anaemic group, and in a multivariate linear regression model, anaemia remained an independent predictor of NT-proBNP. Conclusively, anaemia was found to be a negative prognostic factor for ischemic stroke patients. Furthermore, anaemia influenced the NT-proBNP level in ischemic stroke patients, an important aspect when interpreting NT-proBNP in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / metabolism
  • Anemia / mortality*
  • Anemia / physiopathology
  • Brain Ischemia / metabolism
  • Brain Ischemia / mortality*
  • Brain Ischemia / physiopathology
  • Causality
  • Comorbidity
  • Female
  • Heart Failure / metabolism
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / metabolism*
  • Peptide Fragments / metabolism*
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Regional Blood Flow / physiology
  • Renal Insufficiency / metabolism
  • Renal Insufficiency / mortality
  • Renal Insufficiency / physiopathology
  • Stress, Physiological / metabolism
  • Stress, Physiological / physiopathology
  • Stroke / metabolism
  • Stroke / mortality*
  • Stroke / physiopathology

Substances

  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain