Evidence map›Paper›PMID 24186915›Full record

SynthesisNeurology2013

B-type natriuretic peptides and mortality after stroke: a systematic review and meta-analysis.

Teresa García-Berrocoso, Dolors Giralt, Alejandro Bustamante, Thorleif Etgen, Jesper K Jensen, Jagdish C Sharma, Kensaku Shibazaki, Ayhan Saritas, Xingyong Chen, William N Whiteley and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Prognostic Hemostasis Biomarkers in Acute Ischemic Stroke.Arteriosclerosis, thrombosis, and vascular biology · 2019
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Trial
  10. Review
  11. Article
  12. Article
  13. Injury to repair: Functions of microglia and monocyte-derived cells in ischemic stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Teresa García-BerrocosoFrom the Neurovascular Research Laboratory (T.G.-B., D.G., A.B., J.M.), Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Department of Neurology (T.E.), Kliniken Südostbayern-Klinikum Traunstein, Germany; Department of Psychiatry and Psychotherapy (T.E.), Technische Universität München, Germany; Department of Cardiology (J.K.J.), Odense University, Denmark; Stroke Medicine (J.C.S.), Lincoln County Hospital, University of Nottingham, UK; Department of Stroke Medicine (K.S.), Kawasaki Medical School, Kurashiki City, Okayama, Japan; Department of Emergency Medicine (A.S.), School of Medicine, Duzce University, Turkey; Department of Neurology (X.C.), Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China; and Centre for Clinical Brain Sciences (W.N.W.), University of Edinburgh, UK.
Dolors Giralt
Alejandro Bustamante
Thorleif Etgen
Jesper K Jensen
Jagdish C Sharma
Kensaku Shibazaki
Ayhan Saritas
Xingyong Chen
William N Whiteley
Joan Montaner

Funding

Chief Scientist Office CAF/06/30Medical Research Council G0902303
6 · The paper itself

Abstract

objectiveTo measure the association of B-type natriuretic peptide (BNP) and N-terminal fragment of BNP (NT-proBNP) with all-cause mortality after stroke, and to evaluate the additional predictive value of BNP/NT-proBNP over clinical information.

methodsSuitable studies for meta-analysis were found by searching MEDLINE and EMBASE databases until October 26, 2012. Weighted mean differences measured effect size; meta-regression and publication bias were assessed. Individual participant data were used to estimate effects by logistic regression and to evaluate BNP/NT-proBNP additional predictive value by area under the receiver operating characteristic curves, and integrated discrimination improvement and categorical net reclassification improvement indexes.

resultsLiterature-based meta-analysis included 3,498 stroke patients from 16 studies and revealed that BNP/NT-proBNP levels were 255.78 pg/mL (95% confidence interval [CI] 105.10-406.47, p = 0.001) higher in patients who died; publication bias entailed the loss of this association. Individual participant data analysis comprised 2,258 stroke patients. After normalization of the data, patients in the highest quartile had double the risk of death after adjustment for clinical variables (NIH Stroke Scale score, age, sex) (odds ratio 2.30, 95% CI 1.32-4.01 for BNP; and odds ratio 2.63, 95% CI 1.75-3.94 for NT-proBNP). Only NT-proBNP showed a slight added value to clinical prognostic variables, increasing discrimination by 0.028 points (integrated discrimination improvement index; p < 0.001) and reclassifying 8.1% of patients into correct risk mortality categories (net reclassification improvement index; p = 0.003). Neither etiology nor time from onset to death affected the association of BNP/NT-proBNP with mortality.

conclusionBNPs are associated with poststroke mortality independent of NIH Stroke Scale score, age, and sex. However, their translation to clinical practice seems difficult because BNP/NT-proBNP add only minor predictive value to clinical information.

Indexed as

AnimalsBiomarkersHumansNatriuretic Peptide, BrainStrokeBiomarkersNatriuretic Peptide, Brain

Identifiers

PMID24186915
PMCPMC3854833

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.