Diagnostic Utility of N-Terminal Pro-B-Type Natriuretic Peptide in Identifying Atrial Fibrillation Post-Cryptogenic Stroke: A Systematic Review and Meta-Analysis.

IF 2.7 Q2 PATHOLOGY

Pathophysiology Pub Date : 2024-06-30 DOI:10.3390/pathophysiology31030024

Jay Patel, Sonu M M Bhaskar

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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) significantly contributes to acute ischemic stroke, with undetected AF being a common culprit in cryptogenic strokes. N-terminal pro-B-type natriuretic peptide (NT-proBNP), indicative of myocardial stress, has been proposed as a biomarker for AF detection, aiding in the selection of patients for extended cardiac monitoring. However, the diagnostic accuracy of NT-proBNP remains uncertain.

Methods: We conducted a meta-analysis to evaluate the diagnostic accuracy of NT-proBNP in detecting AF among cryptogenic stroke patients. A comprehensive literature search was conducted across PubMed, Embase, and Cochrane databases to identify relevant studies. Studies reporting NT-proBNP levels in stroke patients and data on the proportion of patients with AF above a specified cut-off were included. Meta-analyses were performed using the midas command in STATA.

Results: Seven studies encompassing 2171 patients were included in the analysis, of which five studies contained cohorts with cryptogenic strokes. Among patients with cryptogenic stroke, NT-proBNP demonstrated a diagnostic accuracy of 80% (Area Under the Receiver Operating Curve 0.80 [95% CI 0.76-0.83]), with a sensitivity of 81% (95% CI 0.68-0.89) and a specificity of 68% (95% CI 0.60-0.75).

Conclusion: Our meta-analysis indicates that NT-proBNP exhibits a good-to-very-good diagnostic accuracy for detecting AF in patients with cryptogenic stroke. These findings suggest potential implications for utilizing NT-proBNP in guiding the selection of patients for prolonged cardiac monitoring, thereby aiding in the management of cryptogenic stroke cases.

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N 端 Pro-B 型钠利尿肽在识别心房颤动隐源性卒中后的诊断效用：系统回顾与元分析》。

背景：心房颤动（房颤）是急性缺血性脑卒中的重要诱因，而未被发现的房颤则是隐源性脑卒中的常见罪魁祸首。提示心肌应激的 N 端前 B 型钠尿肽（NT-proBNP）被认为是检测房颤的生物标志物，有助于选择患者进行长期心脏监测。然而，NT-proBNP 的诊断准确性仍不确定：我们进行了一项荟萃分析，以评估 NT-proBNP 在隐源性卒中患者中检测房颤的诊断准确性。我们在 PubMed、Embase 和 Cochrane 数据库中进行了全面的文献检索，以确定相关研究。纳入了报告卒中患者 NT-proBNP 水平的研究以及房颤患者比例超过特定临界值的数据。使用 STATA 中的 midas 命令进行 Meta 分析：共有 7 项研究纳入分析，涵盖 2171 名患者，其中 5 项研究包含隐源性脑卒中队列。在隐源性卒中患者中，NT-proBNP 的诊断准确率为 80%（接收者工作曲线下面积为 0.80 [95% CI 0.76-0.83]），敏感性为 81%（95% CI 0.68-0.89），特异性为 68%（95% CI 0.60-0.75）：我们的荟萃分析表明，NT-proBNP 对隐源性卒中患者房颤的检测具有良好至非常好的诊断准确性。这些研究结果表明，利用 NT-proBNP 指导选择患者进行长期心脏监测具有潜在的意义，从而有助于隐源性卒中病例的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pathophysiology Medicine-Pathology and Forensic Medicine

CiteScore

3.10

自引率

0.00%

发文量

期刊介绍： Pathophysiology is an international journal which publishes papers in English which address the etiology, development, and elimination of pathological processes. Contributions on the basic mechanisms underlying these processes, model systems and interdisciplinary approaches are strongly encouraged.