Does a reduction in BNP levels after multidisciplinary management reduce one-year mortality in patients with acute cerebral infarction and suspected heart failure?
385 patients with acute cerebral infarction and suspected heart failure (BNP ≥100 pg/dL on admission), median age 84 years.
Improvement in BNP levels (<100 pg/dL) one week after multidisciplinary team (MDT) intervention
Plateau in BNP levels (≥100 pg/dL) one week after multidisciplinary team (MDT) intervention
In-hospital mortality, cerebral infarction recurrence, and one-year mortalityhard clinical
Reduction of BNP to <100 pg/dL following multidisciplinary management is associated with significantly lower one-year mortality in patients with acute ischemic stroke and suspected heart failure.
Abstract Background and aims Approximately 10–20% of patients with stroke have concomitant chronic heart failure (HF), which is associated with increased in-hospital and post-stroke mortality. In our stroke care unit, a multidisciplinary team (MDT) manages patients with suspected HF, defined as brain natriuretic peptide (BNP) ≥100 pg/dL. The aim of this study is to investigate whether changes in BNP following MDT intervention are associated with prognosis in patients with acute cerebral infarction (CI). Methods This retrospective observational study included patients with acute CI and BNP ≥100 pg/dL on admission between August 2022 and December 2024. Patients were classified based on BNP levels one week after MDT intervention into an improvement-group (BNP 100 pg/dL) and a plateau-group (BNP ≥100 pg/dL). In-hospital mortality, CI recurrence, and one-year mortality were compared. Results A total of 385 patients were included (median age 84 years, median BNP 212). The improvement-group comprised 152 patients (39%; median BNP 141 to 60), and the plateau-group included 233 patients (61%; median BNP 275 to 224). Patients in the improvement-group were younger (80 vs 85 years, p0.001) and had lower baseline NIHSS scores (6 vs 10, p0.001). There was no significant difference in MDT-recommended new medications between groups (27.6% vs 24.9%, p=0.549). In-hospital mortality (0% vs 2.1%, p=0.162) and one-year CI recurrence (8.9% vs 4.9%, p=0.167) did not differ significantly, whereas one-year mortality was significantly lower in the improvement-group (2.2% vs 16.5%, p0.001). Conclusions Reduction in BNP levels after MDT intervention was associated with lower one-year mortality in patients with acute CI. Conflict of interest Yuka Terasawa nothing to disclose
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Yuka Terasawa
Hiromi Ihoriya
Yoshinori Miyamoto
European Stroke Journal
Tokushima University Hospital
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Terasawa et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7f0dbfa21ec5bbf07775 — DOI: https://doi.org/10.1093/esj/aakag023.1388