Postoperative BNP independently predicted hemorrhagic transformation in acute ischemic stroke following successful endovascular recanalization (adjusted OR 1.002; 95% CI 1.000-1.004; P=0.048).
Cohort (n=128)
Yes
Does postoperative BNP level predict hemorrhagic transformation in acute ischemic stroke patients with successful endovascular recanalization?
Postoperative BNP levels are significantly elevated in patients with hemorrhagic transformation and may serve as an independent predictor of this complication following successful endovascular recanalization for acute ischemic stroke.
Effect estimate: adjusted OR 1.002 (95% CI 1.000-1.004)
p-value: p=0.048
Hemorrhagic transformation (HT) remains a critical complication following successful endovascular recanalization in acute ischemic stroke (AIS), contributing to adverse clinical outcomes. This two-center retrospective cohort study, designed as an exploratory, hypothesis-generating investigation, aimed to preliminarily explore the potential role of brain natriuretic peptide (BNP) as a predictor of HT in AIS patients with successful endovascular recanalization, and to generate testable hypotheses for subsequent clinical validation. A total of 128 eligible patients were enrolled, including 47 in the HT group and 81 in the non-HT group. Postoperative BNP levels, clinical data, and imaging findings were analyzed. Results showed that postoperative BNP levels were significantly elevated in the HT group compared with the non-HT group (396.46 ± 594.97 vs. 200.74 ± 213.63 pg/ml, P = 0.003). Univariate and multivariate logistic regression analyses demonstrated that BNP was an independent predictor of HT (adjusted OR = 1.002, 95% CI: 1.000-1.004, P = 0.048) after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) for the fully adjusted model (Model 6) was 0.713 (95% CI: 0.620-0.806), indicating good discriminative ability. A nomogram incorporating BNP and other variables showed favorable calibration for predicting HT risk. Mechanistically, integrative analyses of BNP's 3D structure, gene-level networks, and protein interactions revealed its involvement in vascular homeostasis, cardiac function, and inflammation-key pathways in HT pathogenesis. In conclusion, this hypothesis-generating study provides preliminary exploratory evidence that postoperative BNP is a potential predictive biomarker of HT in AIS patients with successful endovascular recanalization. Our findings generate a testable clinical hypothesis for future validation, with potential clinically relevant value for risk stratification and personalized clinical management after prospective confirmation.
Yang et al. (Tue,) conducted a cohort in Acute ischemic stroke with successful endovascular recanalization (n=128). Brain natriuretic peptide (BNP) was evaluated on Hemorrhagic transformation (adjusted OR 1.002, 95% CI 1.000-1.004, p=0.048). Postoperative BNP independently predicted hemorrhagic transformation in acute ischemic stroke following successful endovascular recanalization (adjusted OR 1.002; 95% CI 1.000-1.004; P=0.048).