Ability of B-Type Natriuretic Peptide Testing to Predict Cardioembolic Stroke in the General Population ― Comparisons With C-Reactive Protein and Urinary Albumin ―
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- Nakamura Motoyuki
- Department of Internal Medicine, Iwate Medical University
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- Ishibashi Yasuhiro
- Department of Internal Medicine, Iwate Medical University
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- Tanaka Fumitaka
- Department of Internal Medicine, Iwate Medical University
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- Omama Shinichi
- Department of Neurosurgery, Iwate Medical University
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- Onoda Toshiyuki
- Department of Hygiene and Preventive Medicine, Iwate Medical University
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- Takahashi Tomohiro
- Department of Internal Medicine, Iwate Medical University
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- Takahashi Shuko
- Department of Internal Medicine, Iwate Medical University
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- Tanno Kozo
- Department of Hygiene and Preventive Medicine, Iwate Medical University
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- Ohsawa Masaki
- Department of Internal Medicine, Iwate Medical University
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- Sakata Kiyomi
- Department of Hygiene and Preventive Medicine, Iwate Medical University
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- Koshiyama Makoto
- Iwate Health Service Association
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- Ogasawara Kuniaki
- Department of Neurosurgery, Iwate Medical University
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- Okayama Akira
- The Research Institute of Strategy for Prevention
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Description
<p>Background:The ability of cardiovascular biomarkers to predict the incidence of stroke subtypes remains ill-defined in the general population.</p><p>Methods and Results:The blood levels of B-type natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hs-CRP) and urinary albumin corrected by urinary creatinine (UACR) were determined in a general population (n=13,575). The ability to predict the incidence of ischemic stroke subtypes (lacunar, atherothrombotic, cardioembolic) for each biomarker was assessed based on the area under the receiver-operating characteristic curve (AUC-ROC) and using Cox proportional hazard modeling. The predictive abilities of UACR and hs-CRP for any subtype of ischemic event were found to be suboptimal. However, the ability of BNP to predict the incidence of cardioembolic stroke was excellent (AUC-ROC=0.81). When BNP was added to established stroke risk factors, the ability to predict cardioembolic stroke in terms of the AUC-ROC significantly improved (4-year follow-up, P=0.018; 8-year follow-up, P=0.009). Furthermore, when BNP was added to the JPHC score, the ability to predict cardioembolic stroke was significantly improved (net reclassification improvement=0.968, P<0.0001: integrated discrimination improvement=0.039, P<0.05).</p><p>Conclusions:In the general population, plasma BNP was an excellent biomarker for predicting the incidence of cardioembolic stroke when used alone or in combination with established stroke risk factors.</p>
Journal
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- Circulation Journal
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Circulation Journal 82 (4), 1017-1025, 2018
The Japanese Circulation Society
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Details 詳細情報について
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- CRID
- 1390001205106496512
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- NII Article ID
- 130006528570
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- NII Book ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL BIB ID
- 028895192
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- PubMed
- 29386475
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL Search
- Crossref
- PubMed
- CiNii Articles
- KAKEN
- OpenAIRE
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- Abstract License Flag
- Disallowed