5
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      The Prognostic Value of Midregional Proatrial Natriuretic Peptide in Patients with Hemorrhagic Stroke

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Atrial natriuretic peptide (ANP) is a well-known prognostic marker of outcome and mortality in patients with cardiovascular disease. Midregional proatrial natriuretic peptide (MR-proANP) is a stable fragment of the ANP precursor hormone. As a prognostic marker after ischemic stroke, it reliably predicts poststroke mortality and functional outcome. This study aimed to analyze the prognostic value of MR-proANP in patients with hemorrhagic stroke, i.e. subarachnoid (SAH) and intracerebral hemorrhage (ICH). Methods: MR-proANP was analyzed in patients with spontaneous SAH or spontaneous ICH. All patients were prospectively randomized into two treatment arms: (1) a prophylactic normothermia group with a target core temperature 36.5°C using endovascular cooling, and (2) a control group with conventional stepwise predefined fever management using antipyretic medication and surface cooling. Blood samples were obtained on admission and on days 4 and 7. Measurement of MR-proANP was performed in serum using sandwich immunoassay. The primary endpoint was functional outcome [assessed by the Glasgow Outcome Score (GOS)] and the secondary endpoints were mortality within 180 days after hemorrhagic stroke and influence of temperature on MR-proANP. A favorable outcome was defined as GOS 4-5, and the patients were considered to have a poor outcome with a 180-day GOS score between 1 and 3. Results: Analysis of MR-proANP was performed in 24 patients with spontaneous SAH and 22 patients with spontaneous ICH. MR-proANP was elevated on days 4 and 7 as compared to baseline levels (p < 0.05 and p < 0.001, respectively). High MR-proANP levels (>120 pmol/l) were associated with increased mortality and poor outcome (after 180 days; p < 0.05, respectively). There was no significant difference regarding MR-proANP serum concentrations between the endovascular and the control groups. Conclusions: Increased levels of MR-proANP are independently associated with poor functional outcome and increased mortality after 180 days in patients with hemorrhagic stroke. Endovascular temperature control had no significant influence on MR-proANP levels.

          Related collections

          Most cited references 24

          • Record: found
          • Abstract: not found
          • Article: not found

          Natriuretic peptides.

            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Spontaneous intracerebral hemorrhage.

              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Aneurysmal subarachnoid hemorrhage.

                Bookmark

                Author and article information

                Journal
                CED
                Cerebrovasc Dis
                10.1159/issn.1015-9770
                Cerebrovascular Diseases
                S. Karger AG
                1015-9770
                1421-9786
                2014
                February 2014
                30 January 2014
                : 37
                : 2
                : 128-133
                Affiliations
                aDepartment of Neurology, Innsbruck Medical University, Innsbruck, Austria; bDepartment of Neurology, Universitätsspital Zürich, Zürich, and cMedical University Department of the University of Basel, Kantonsspital Aarau, Aarau, Switzerland; dInstitut für Experimentelle Endokrinologie und Endokrinologisches Forschungszentrum, EnForCé, Charité, Campus Virchow, Berlin, and eClinical Diagnostics, Thermo Scientific Biomarkers, Thermo Fisher Scientific, Hennigsdorf, Germany
                Author notes
                *Gregor Broessner, MD, Assistant Professor of Neurology, Innsbruck Medical University, Department of Neurology, Neurologic Intensive Care Unit, Anichstrasse 35, AT-6020 Innsbruck (Austria), E-Mail gregor.broessner@i-med.ac.at
                Article
                357215 Cerebrovasc Dis 2014;37:128-133
                10.1159/000357215
                24481415
                © 2014 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 3, Tables: 1, Pages: 6
                Categories
                Original Paper

                Comments

                Comment on this article