Procalcitonin and Midregional Proatrial Natriuretic Peptide as Biomarkers of Subclinical Cerebrovascular Damage
| Autor: | Kathartina Spanaus, Ralph L. Sacco, Mira Katan, Clinton B. Wright, Yeseon P. Moon, Arnold von Eckardstein, Janet T. DeRosa, Jose Gutierrez, Mitchell S.V. Elkind, Charles DeCarli |
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| Rok vydání: | 2017 |
| Předmět: |
Advanced and Specialized Nursing
Pathology medicine.medical_specialty business.industry medicine.drug_class Odds ratio 030204 cardiovascular system & hematology medicine.disease Procalcitonin Hyperintensity 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Natriuretic peptide Cardiology Biomarker (medicine) Neurology (clinical) Risk factor Cardiology and Cardiovascular Medicine business Stroke 030217 neurology & neurosurgery Subclinical infection |
| Zdroj: | Stroke. 48:604-610 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.116.014945 |
| Popis: | Background and Purpose— Chronic infections and cardiac dysfunction are risk factors for stroke. We hypothesized that blood biomarkers of infection (procalcitonin) and cardiac dysfunction (midregional proatrial natriuretic peptide [MR-proANP]), previously associated with small vessel stroke and cardioembolic stroke are also associated with subclinical cerebrovascular damage, including silent brain infarcts and white matter hyperintensity volume. Methods— The NOMAS (Northern Manhattan Study) was designed to assess risk factors for incident vascular disease in a multiethnic cohort. A subsample underwent brain magnetic resonance imaging and had blood samples available for biomarker measurement (n=1178). We used logistic regression models to estimate the odds ratios and 95% confidence intervals (95% CIs) for the association of these biomarkers with silent brain infarcts after adjusting for demographic, behavioral, and medical risk factors. We used linear regression to assess associations with log-white matter hyperintensity volume. Results— Mean age was 70±9 years; 60% were women, 66% Hispanic, 17% black, and 15% were white. After adjusting for risk factors, subjects with procalcitonin or MR-proANP in the top quartile, compared with the lowest quartile were more likely to have silent brain infarcts (adjusted odds ratio for procalcitonin, 2.2; 95% CI, 1.3–3.7 and for MR-proANP, 3.3; 95% CI, 1.7–6.3) and increased white matter hyperintensity volume (adjusted mean change in log-white matter hyperintensity volume for procalcitonin, 0.29; 95% CI, 0.13–0.44 and for MR-proANP, 0.18; 95% CI, 0.004–0.36). Conclusions— Higher concentrations of procalcitonin, a marker of infection, and MR-proANP, a marker of cardiac dysfunction, are independently associated with subclinical cerebrovascular damage. If further studies demonstrate an incremental value for risk stratification, biomarker-guided primary prevention studies may lead to new approaches to prevent cerebrovascular disease. |
| Databáze: | OpenAIRE |
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