OBJECTIVE: To investigate the significance of N-terminal proBrain natriuretic 
peptide (NT-proBNP) in predicting the outcome of acute stroke in relation to 
other cardiovascular variables and stroke severity.
DESIGN: Prospective study of previously independent acute ischemic and 
hemorrhagic stroke patients admitted to the acute stroke ward.
METHODS: Measurements of NT-proBNP in acute phase in addition to standard 
assessment of cardiovascular and neurological details.
MAIN OUTCOME MEASURES: Concentrations and significance of NT-proBNP in patients 
who were dead versus alive at 120 days after acute stroke and Cox regression 
analysis with stroke severity measured as Scandinavian Stroke Scale (SSS) and 
other cardiovascular disease to predict mortality.
RESULTS: One hundred fourteen patients were recruited, median age 74 years. At 
120 days, 13 patients had died. Deceased patients had a significantly higher 
concentration of NT-proBNP as compared to alive patients (P < .001). All 
patients who had died had NT-proBNP concentration above the median for the whole 
group. Cox regression analysis revealed that NT-proBNP was the most significant 
independent variable predicting mortality (odds ratio [OR] 2.4, 95% confidence 
interval [CI] 1.35 to 4.41, P = .003) followed by the SSS (OR 0.95, 95% CI 0.90 
to 0.98, P = .005). Higher NT-proBNP and lower SSS predicted mortality. There 
was a significant negative correlation of NT-proBNP with SSS score (r = -0.24, P 
= .02). There were no significant difference in NT-proBNP concentrations between 
ischemic and hemorrhagic strokes (P < .346). At 6 weeks, the dependent patients 
had higher concentrations of NT-proBNP than independent patients.
CONCLUSION: NT-proBNP, an index of cardiac impairment, has an independent 
prognostic value in acute stroke patients over other cardiovascular variables 
and stroke severity. This may provide a channel for interventional therapy in 
acute stroke.