22. European Stroke Conference 488 © 2013 S. Karger AG, Basel Scientific Programme 381 Heart and brain HIGH pro-BNP LEVELS PREDICT THE DEVELOPMENT OF ATRIAL FIBRILLATION AFTER CRYPTOGENIC ISCHEMIC STROKE M. Rodríguez-Yáñez1, S. Arias-Rivas2, A. López-Ferreiro3, A. Vieites4, R. Andrade5, J. Castillo6, M. Blanco7 Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Uni-versitario, IDIS, Santiago de Compostela, SPAIN1, Department of Neurology, Clinical Neurosci-ences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN2, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Univer-sitario, IDIS, Santiago de Compostela, SPAIN3, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN4, De-partment of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN5, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, Santiago de Compostela, SPAIN6, Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, IDIS, San-tiago de Compostela, SPAIN7 Introduction: One third of patients with ischemic stroke have a cryptogenic stroke. International guidelines recommend the use of antiplatelets for secondary prevention, but some patients may pres-ent a cardioembolic source that has not been detected. We ignore what kind of patients with crypto-genic stroke can develop atrial fibrillation (AF). High pro-BNP levels are associated with cardioem-bolic stroke. Our objective is to determine whether pro-BNP levels in acute phase of stroke predict the development of AF in patients with cryptogenic stroke. Patients and methods: Prospective study including patients from February 2008 to July 2011 with cryptogenic stroke. Demographic data, medical history and stroke characteristics were assessed at admission. Blood sample was obtained within the first 24 hours from stroke onset to determine pro-BNP levels. Clinical and electrocar-diogram evaluation was performed by a neurologist at 3 and 6 months and later by primary care physician for 2 years. Results: One thousand and fifty patients were evaluated. Three hundred sev-enty- two patients (35%) had cryptogenic stroke. Two hundred sixty-four patients were valid for the analysis. Fifteen patients (5.6%) developed AF. Variables associated with AF development were age, hypertension and higher levels of pro-BNP. In the logistic regression model we found that pro-BNP ≥360 pg/mL were the only variable independently associated with the risk of development of AF (OR: 5.70; CI 95%: 1.11-29.29, p=0.037). Conclusions: Pro-BNP ≥360 pg/mL increase in 5-fold the risk of development of AF after a cryptogenic ischemic stroke.
Karger_ESC London_2013
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