Open AccessPrognostic Value of a Single Prehospital Measurement of N-Terminal Pro-Brain Natriuretic Peptide and Troponin T after Acute Ischaemic Stroke
Author(s) -
EH Hajdinjak,
Petra Klemen,
Štefek Grmec
Publication year - 2012
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/147323001204000243
Subject(s) - medicine , troponin , natriuretic peptide , stroke (engine) , receiver operating characteristic , troponin t , cardiology , troponin i , logistic regression , emergency department , area under the curve , triage , prospective cohort study , odds ratio , myocardial infarction , emergency medicine , heart failure , mechanical engineering , psychiatry , engineering
OBJECTIVE: Data regarding the value of prehospital measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T as prognostic indicators of in-hospital mortality are limited. This prospective pilot study aimed to determine the value of a single combined measurement of NT-proBNP and troponin T for predicting in-hospital mortality in patients with acute ischaemic stroke in a prehospital emergency medicine centre. METHODS: Blood samples were collected in the prehospital setting and analysed for NT-proBNP and troponin T, using a portable device. Parameters previously associated with stroke severity (including prognostic scoring systems) were recorded and assessed as independent predictors of in-hospital mortality. RESULTS: In logistic regression analysis, elevated troponin T (odds ratio [OR] 1.8 [95% CI 1.1, 8.4) and elevated NT-proBNP (OR 5.80 [95% CI 1.3, 22.7]) were significantly associated with poor outcome in patients with acute ischaemic stroke. Combined measurement of troponin T plus NT-proBNP was most predictive of survival in stroke patients (93% sensitivity, 96% specificity, 80% negative predictive value, 98% positive predictive value and 92% area under the receiver operating curve). CONCLUSIONS: NT-proBNP and troponin T levels, measured during the prehospital phase of care after acute ischaemic stroke, are strong predictors of in-hospital mortality.