著者
Kenji Ebihara Kazumasa Yamagishi Mitsumasa Umesawa Isao Muraki Renzhe Cui Hironori Imano Yasuhiko Kubota Mina Hayama-Terada Yuji Shimizu Tetsuya Ohira Tomoko Sankai Takeo Okada Akihiko Kitamura Masahiko Kiyama Hiroyasu Iso for the CIRCS Investigators
出版者
Japan Atherosclerosis Society
雑誌
Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日
pp.52241, (Released:2020-01-11)
参考文献数
30
被引用文献数
3

Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. Methods: We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. Results: During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14–28.0) for ischemic stroke and 6.81 (1.11–41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. Conclusion: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.

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【NT-proBNP中等度上昇でも脳卒中リスク高?:CIRCS/ JAT】 日本、住民コホート4393名、4.7年観察:1.1%が脳卒中発症。追跡開始時NT-proBNP最高四分位群では、最低群に比べ、諸因子補正後の脳卒中HRが7.29 [95%CI 2.82-18.9]。第三四分位群でも2.78 [1.25-6.16]。 https://t.co/0nXuOFoCD9

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