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The relation between electrocardiographic ST-T changes and NT-proBNP in patients with acute ischemic stroke

Background. ST-segment depression and T-wave inversion (ST-T changes) in the electrocardiogram (ECG) and raised levels of natriuretic peptide have been observed in acute ischemic stroke patients. It is unknown whether any relation between ST-T changes and raised levels of natriuretic peptides in patients with an acute ischemic stroke exists. Methods. Serial measurements of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 12-lead ECGs were obtained in 192 consecutive patients with an acute ischemic stroke without ischemic heart disease, atrial fibrillation, heart- or renal failure. Results. ST-T changes suggestive of myocardial ischemia were observed in the 12 lead ECG of 47 patients (24%). In uni- and multivariate regression analysis after adjustment for age, stroke severity, female sex, systolic blood pressure, diabetes mellitus, and levels of troponin T > 0.03 µg/L, ST-T changes in the ECG remained associated with increased levels of NT-proBNP (β=76.5, p=0.011). Conclusions. ST-T changes suggestive of myocardial ischemia are independently associated with the levels of NT-proBNP in patients with acute ischemic stroke. The clinical importance of this observation remains to be defined.