MR-proANP levels in Acute ischemic stroke and clinical outcomes: a systematic review and meta-analysis.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Basel Musmar, Hamza Adel Salim, Brian Mac Grory, Fares Musmar, Samantha Spellicy, Jihad Abdelgadir, Nimer Adeeb, David Hasan
{"title":"MR-proANP levels in Acute ischemic stroke and clinical outcomes: a systematic review and meta-analysis.","authors":"Basel Musmar, Hamza Adel Salim, Brian Mac Grory, Fares Musmar, Samantha Spellicy, Jihad Abdelgadir, Nimer Adeeb, David Hasan","doi":"10.1007/s10143-024-03073-w","DOIUrl":null,"url":null,"abstract":"<p><p>In patients with acute ischemic stroke, midregional proatrial natriuretic peptide (MR-proANP) has shown promise in preliminary studies for risk stratification. The objective of this study is to evaluate the prognostic utility of MR-proANP in AIS, focusing on its ability to predict 90-day functional outcomes, mortality rates, and the presence of atrial fibrillation (Afib). A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus, following PRISMA guidelines. The search strategy employed a combination of keywords and index terms including \"Acute Ischemic Stroke,\" \"AIS,\" \"Cerebral Infarction,\" \"Atrial Fibrillation,\" \"AFib,\" \"stroke,\" \"MR-proANP,\" \"Mid-regional pro-atrial natriuretic peptide,\" and \"proatrial natriuretic peptide.\" Inclusion criteria encompassed any study focusing on MR-proANP and ischemic stroke, published up to October 15, 2023. Primary end points were newly diagnosed Afib, 90-day Modified Rankin Scale (mRS) score, and 90-day mortality. Studies were described in narrative and tabular form. Risk of bias was assessed using the ROBINS-I tool. Pooled estimates for our key end points were generated using a random effects model where appropriate. MR-proANP levels were significantly elevated in newly diagnosed Afib patients compared to no Afib patients (mean difference (MD): 134.4 pmol/l; 95% confidence interval (CI): 119.45 to 149.35, P < 0.0001). Unfavorable functional outcomes, as measured by mRS scores of ≥ 3 at 90 days, were associated with higher levels of MR-proANP (MD: 93.87 pmol/; 95% CI: 76.66 to 111.09, P < 0.0001). Elevated MR-proANP levels were also strongly correlated with increased 90-day mortality rates (MD: 164.43 pmol/; CI: 95.94 to 232.92, P < 0.0001). MR-proANP was significantly associated with functional outcomes, 90-day mortality, and the newly diagnosed AF. The limited number of studies included calls for further large-scale research to confirm these findings and explore the potential for expedited diagnostic procedures and targeted interventions like anticoagulant therapy.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"835"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurosurgical Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10143-024-03073-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

In patients with acute ischemic stroke, midregional proatrial natriuretic peptide (MR-proANP) has shown promise in preliminary studies for risk stratification. The objective of this study is to evaluate the prognostic utility of MR-proANP in AIS, focusing on its ability to predict 90-day functional outcomes, mortality rates, and the presence of atrial fibrillation (Afib). A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus, following PRISMA guidelines. The search strategy employed a combination of keywords and index terms including "Acute Ischemic Stroke," "AIS," "Cerebral Infarction," "Atrial Fibrillation," "AFib," "stroke," "MR-proANP," "Mid-regional pro-atrial natriuretic peptide," and "proatrial natriuretic peptide." Inclusion criteria encompassed any study focusing on MR-proANP and ischemic stroke, published up to October 15, 2023. Primary end points were newly diagnosed Afib, 90-day Modified Rankin Scale (mRS) score, and 90-day mortality. Studies were described in narrative and tabular form. Risk of bias was assessed using the ROBINS-I tool. Pooled estimates for our key end points were generated using a random effects model where appropriate. MR-proANP levels were significantly elevated in newly diagnosed Afib patients compared to no Afib patients (mean difference (MD): 134.4 pmol/l; 95% confidence interval (CI): 119.45 to 149.35, P < 0.0001). Unfavorable functional outcomes, as measured by mRS scores of ≥ 3 at 90 days, were associated with higher levels of MR-proANP (MD: 93.87 pmol/; 95% CI: 76.66 to 111.09, P < 0.0001). Elevated MR-proANP levels were also strongly correlated with increased 90-day mortality rates (MD: 164.43 pmol/; CI: 95.94 to 232.92, P < 0.0001). MR-proANP was significantly associated with functional outcomes, 90-day mortality, and the newly diagnosed AF. The limited number of studies included calls for further large-scale research to confirm these findings and explore the potential for expedited diagnostic procedures and targeted interventions like anticoagulant therapy.

急性缺血性脑卒中中 MR-proANP 水平与临床预后:系统综述与荟萃分析。
在对急性缺血性卒中患者进行风险分层的初步研究中,中区前房性钠尿肽(MR-proANP)显示了其前景。本研究的目的是评估 MR-proANP 在 AIS 中的预后作用,重点关注其预测 90 天功能预后、死亡率和是否存在心房颤动(Afib)的能力。按照 PRISMA 指南,我们使用 PubMed、Web of Science 和 Scopus 进行了全面的文献检索。搜索策略采用了关键词和索引词的组合,包括 "急性缺血性卒中"、"AIS"、"脑梗塞"、"心房颤动"、"心房颤动纤颤"、"卒中"、"MR-proANP"、"中区域前房性钠肽 "和 "前房性钠肽"。纳入标准包括截至 2023 年 10 月 15 日发表的任何关注 MR-proANP 和缺血性中风的研究。主要终点为新诊断的阿非布、90 天改良 Rankin 量表 (mRS) 评分和 90 天死亡率。研究以叙述和表格形式进行描述。采用 ROBINS-I 工具评估偏倚风险。在适当的情况下,采用随机效应模型对关键终点进行汇总估计。与无阿菲卜患者相比,新诊断的阿菲卜患者的MR-proANP水平明显升高(平均差(MD):134.4 pmol/l;95% 置信区间(CI):119.45 至 149.35,P
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信