Annals of Indian Academy of Neurology
  Users Online: 2604 Home | About the Journal | InstructionsCurrent Issue | Back IssuesLogin      Print this page Email this page  Small font size Default font size Increase font size

Table of Contents
LETTER TO THE EDITOR
Year : 2014  |  Volume : 17  |  Issue : 2  |  Page : 243
 

Brain natriuretic peptide among stroke patients


1 Department of Emergency Medicine, Duzce University School of Medicine, Duzce, Turkey
2 Department of Emergency Medicine, Ataturk University School of Medicine, Erzurum, Turkey

Date of Web Publication17-May-2014

Correspondence Address:
Ayhan Saritas
Department of Emergency Medicine, Duzce University School of Medicine, 81620, Duzce
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.132667

Rights and Permissions

 



How to cite this article:
Saritas A, Cakir Z. Brain natriuretic peptide among stroke patients. Ann Indian Acad Neurol 2014;17:243

How to cite this URL:
Saritas A, Cakir Z. Brain natriuretic peptide among stroke patients. Ann Indian Acad Neurol [serial online] 2014 [cited 2019 Dec 8];17:243. Available from: http://www.annalsofian.org/text.asp?2014/17/2/243/132667


Sir,

We thank Dr. Wu et al.[1] for their interest in our article named "A prospective study of brain natriuretic peptide (BNP) levels in three subgroups: Stroke with hypertension, stroke without hypertension, and hypertension alone." [2] Early prediction of fatal outcome after stroke might improve decision-making processes. The role of BNP and N-terminal of the prohormone BNP (NT-proBNP) as independent predictors of all-cause mortality after stroke. [3] BNP has a significant association with mortality and functional outcome, in recent times studies. [4],[5]

Dr. Wu et al. have claimed that the including patients in Group I and II could not be representative of the classical stroke types. However, patients in Group I and II were typically classical stroke and they were scored according to the National Institutes of Health Stroke Scale (NIHSS). Furthermore, Dr. Wu et al. have claimed that serious bias in our study. These are very heavy and unfair allegations. We do not certainly agree to these allegations. There is no any bias in our study. Several cardiac abnormalities such as cardiac failure, myocardial necrosis, and arrhythmia can develop in acute stroke patients. These cardiac changes may cause increased BNP production by the heart. [6],[7],[8] Therefore, our study the relationship between BNP levels and acute ischemic stroke (AIS) correctly. It is better to exclude those stroke patients who also have cardiac pathologies. In our study, patients with congestive heart failure, chronic cor pulmonale, severe valvular heart disease, chronic renal failure, liver insufficiency, diabetes mellitus, and atrial fibrillation were excluded from the study, especially. Because these diseases can affect the plasma BNP levels. The mean BNP levels in our study subjects were affected only by hypertension and stroke.

Another criticism made by Dr. Wu et al. is that we did not classify the AIS patients into any subtypes. They are right about that. We only classified the stroke patients into two subtypes ischemic and hemorrhagic.

Garcνa-Berrocoso et al. [3] have reported that BNPs (both BNP and NT-proBNP) are associated with post stroke mortality independent of NIHSS score, age, and sex in their meta-analysis. [3] Furthermore, we agree with Dr. Wu et al. opinion about the value of the use of BNP in AIS patients.

 
   References Top

1.Wu Z, He M, Gao S, Yang L. Opinions about the use of brain natriuretic peptide among acute ischemic stroke patients. Ann Indian Acad Neurol 2013;16:726.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Cakir Z, Saritas A, Emet M, Aslan S, Akoz A, Gundogdu F. A prospective study of brain natriuretic peptide levels in three subgroups: Stroke with hypertension, stroke without hypertension, and hypertension alone. Ann Indian Acad Neurol 2010;13:47-51.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.García-Berrocoso T, Giralt D, Bustamante A, Etgen T, Jensen JK, Sharma JC, et al. B-type natriuretic peptides and mortality after stroke: A systematic review and meta-analysis. Neurology 2013;81:1976-85.  Back to cited text no. 3
    
4.Whiteley W, Wardlaw J, Dennis M, Lowe G, Rumley A, Sattar N, et al. The use of blood biomarkers to predict poor outcome after acute transient ischemic attack or ischemic stroke. Stroke 2012;43:86-91.  Back to cited text no. 4
    
5.Montaner J, García-Berrocoso T, Mendioroz M, Palacios M, Perea-Gainza M, Delgado P, et al. Brain natriuretic peptide is associated with worsening and mortality in acute stroke patients but adds no prognostic value to clinical predictors of outcome. Cerebrovasc Dis 2012;34:240-5.  Back to cited text no. 5
    
6.Duygu H, Türk U, Zoghi M, Nalbantgil S. The importance of plasma B-type natriuretic peptide levels in cardiovascular diseases. Anadolu Kardiyol Derg 2005;5:305-11.  Back to cited text no. 6
    
7.Oppenheimer SM, Lima J. Neurology and the heart. J Neurol Neurosurg Psychiatry 1998;64:289-97.  Back to cited text no. 7
    
8.Myers MG, Norris JW, Hachinski VC, Weingert ME, Sole MJ. Cardiac sequelae of acute stroke. Stroke 1982;13:838-42.  Back to cited text no. 8
    




 

Top
Print this article  Email this article

    

 
   Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (269 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    References

 Article Access Statistics
    Viewed1024    
    Printed23    
    Emailed0    
    PDF Downloaded52    
    Comments [Add]    

Recommend this journal