Elevated NT-pro-BNP levels (median 369 vs. 64 pg/mL) and traditional cardiovascular risk factors significantly predicted ischemic stroke in adults with congenital heart disease.
Do baseline cardiorenal biomarkers and traditional cardiovascular risk factors predict incident ischemic stroke in adults with congenital heart disease?
In adults with congenital heart disease, incident ischemic stroke is driven primarily by traditional cardiovascular risk factors and elevated NT-pro-BNP rather than anatomical disease complexity.
Absolute Event Rate: 0% vs 0%
Background/Objectives: Adults with congenital heart disease (CHD) have a substantially higher risk of ischemic stroke than the general population. Circulating biomarkers such as N-terminal pro B-type natriuretic peptide (NT-pro-BNP), high-sensitivity C-reactive protein (hs-CRP), and microalbuminuria have been associated with adverse cardiovascular outcomes in CHD, but their role in predicting cerebrovascular events remains uncertain. Methods: Prospective cohort study including 372 adults with CHD median age 34 years (IQR 23–42); 57.8% male followed at a tertiary center between 2017 and 2022. Baseline assessments included demographic characteristics, CHD anatomical complexity, cardiovascular risk factors, NT-pro-BNP, hs-CRP, lipid profile, and 24-h urinary albumin excretion. The primary endpoint was incident ischemic stroke during a median follow-up of 6.3 years (IQR 3.9–8.3). Univariable Cox proportional hazards models were used to identify predictors of stroke. Results: During follow-up, 13 patients (3.5%) experienced ischemic stroke. Patients with stroke were significantly older 51 (46–64) vs. 30 (23–40) years; p < 0.001 and had a higher prevalence of dyslipidemia (61.5% vs. 15.0%; p < 0.001). NT-pro-BNP levels were markedly higher in patients with stroke 369 (218–604) vs. 64 (21–172) pg/mL; p < 0.001. No significant differences were observed between groups in renal function parameters, hs-CRP, thyroid-stimulating hormone, or urinary albumin excretion rate. In Cox analyses, older age and dyslipidemia were the strongest predictors of stroke (p < 0.001). Arterial hypertension, diabetes mellitus, and higher NT-pro-BNP levels were also associated with increased stroke risk (p < 0.05), whereas CHD anatomical complexity, NYHA functional class, and cyanosis were not. Conclusions: In adults with CHD, ischemic stroke was mainly associated with traditional cardiovascular risk factors and elevated NT-pro-BNP levels rather than anatomical disease complexity or functional status.
Martínez-Quintana et al. (Mon,) reported a other. Elevated NT-pro-BNP levels (median 369 vs. 64 pg/mL) and traditional cardiovascular risk factors significantly predicted ischemic stroke in adults with congenital heart disease.