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. 2017 Mar;48(3):604-610.
doi: 10.1161/STROKEAHA.116.014945. Epub 2017 Jan 25.

Procalcitonin and Midregional Proatrial Natriuretic Peptide as Biomarkers of Subclinical Cerebrovascular Damage: The Northern Manhattan Study

Mira Katan  1 , Yeseon Moon  2 , Arnold von Eckardstein  2 , Kathartina Spanaus  2 , Janet DeRosa  2 , Jose Gutierrez  2 , Charles DeCarli  2 , Clinton Wright  2 , Ralph Sacco  2 , Mitchell Elkind  2
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Procalcitonin and Midregional Proatrial Natriuretic Peptide as Biomarkers of Subclinical Cerebrovascular Damage: The Northern Manhattan Study

Mira Katan et al. Stroke. 2017 Mar.

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.

Keywords: biomarkers; brain infarction; risk factor; stroke; white matter.

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Figures

Figure 1
Figure 1
Distribution of logPCT concentrations according to the presence of silent brain infarcts (SBI).
Figure 2
Figure 2
Distribution of logMRproANP concentrations according to the presence of silent brain infarcts (SBI).
See this image and copyright information in PMC

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