Procalcitonin and Midregional Proatrial Natriuretic Peptide as Biomarkers of Subclinical Cerebrovascular Damage: The Northern Manhattan Study. Issue 3 (March 2017)

• Record Type: Journal Article
• Authors: Katan, Mira; Moon, Yeseon; von Eckardstein, Arnold; Spanaus, Kathartina; DeRosa, Janet; Gutierrez, Jose; DeCarli, Charles; Wright, Clinton; Sacco, Ralph; Elkind, Mitchell
• Is Part Of: Stroke. Volume 48:Issue 3(2017)
• Publication Date: 2017-03
• Subjects: biomarkers -- brain infarction -- risk factor -- stroke -- white matter; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.116.014945
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: Chronic infections and cardiac dysfunction are risk factors for stroke. We hypothesized that blood biomarkers of infection (procalcitonin) and cardiac dysfunction (midregional proatrial natriuretic peptide [MR-proANP]), previously associated with small vessel stroke and cardioembolic stroke are also associated with subclinical cerebrovascular damage, including silent brain infarcts and white matter hyperintensity volume. Methods—: The NOMAS (Northern Manhattan Study) was designed to assess risk factors for incident vascular disease in a multiethnic cohort. A subsample underwent brain magnetic resonance imaging and had blood samples available for biomarker measurement (n=1178). We used logistic regression models to estimate the odds ratios and 95% confidence intervals (95% CIs) for the association of these biomarkers with silent brain infarcts after adjusting for demographic, behavioral, and medical risk factors. We used linear regression to assess associations with log-white matter hyperintensity volume. Results—: Mean age was 70±9 years; 60% were women, 66% Hispanic, 17% black, and 15% were white. After adjusting for risk factors, subjects with procalcitonin or MR-proANP in the top quartile, compared with the lowest quartile were more likely to have silent brain infarcts (adjusted odds ratio for procalcitonin, 2.2; 95% CI, 1.3–3.7 and for MR-proANP, 3.3; 95% CI, 1.7–6.3) and increased white matter hyperintensity volume (adjusted mean change in log-white matter hyperintensity volume for procalcitonin, 0.29; 95% CI, 0.13–0.44 and for MR-proANP, 0.18; 95% CI, 0.004–0.36). Conclusions—: Higher concentrations of procalcitonin, a marker of infection, and MR-proANP, a marker of cardiac dysfunction, are independently associated with subclinical cerebrovascular damage. If further studies demonstrate an incremental value for risk stratification, biomarker-guided primary prevention studies may lead to new approaches to prevent cerebrovascular disease.