{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:07:55Z","timestamp":1789553275342,"version":"build-2803163510"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The dynamic changes of neurological function frequently occur after ischemic stroke, while the underlying mechanisms remain unclear. Given cardiac pathologies from heart\u2010brain axis may contribute to neurological decline, we aimed to investigate associations between cardiac biomarkers and long\u2010term neurological deficits (ND) trajectory after ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We derived data from China Antihypertensive Trial in Acute Ischemic Stroke, circulating NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide), sST2 (soluble ST2), and GDF\u201015 (growth differentiation factor 15) concentrations were measured. We applied group\u2010based trajectory modeling to identify ND trajectories using National Institutes of Health Stroke Scale scores measured at admission, 14\u2009days\/hospital discharge, and 3\u2010month, 12\u2010month, and 24\u2010month follow\u2010up visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We identified 3 ND trajectories: mild, moderate, and persistent\u2010severe. Compared with the lowest tertile, the odds ratios for the highest tertiles of NT\u2010proBNP, sST2, and GDF\u201015 for persistent\u2010severe ND trajectory were 2.20 (95% CI, 1.61\u20132.99), 3.52 (95% CI, 2.58\u20134.82), and 2.09 (95% CI, 1.54\u20132.84), respectively. Patients with \u22652 elevated biomarkers had higher risks of moderate ND and persistent\u2010severe ND trajectories (both\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05). Because National Institutes of Health Stroke Scale scores of moderate and mild ND trajectories remained &lt;5 after discharge, when we merged them into a \u201cminor stroke\u201d group, NT\u2010proBNP, sST2, and GDF\u201015 were still associated with persistent\u2010severe stroke (versus minor stroke). Simultaneously adding 3 biomarkers to the conventional factors model provided significant incremental value for the risk stratification of persistent\u2010severe stroke (net reclassification improvement ranging from 40.5% to 58.1%, all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardiac biomarkers were associated with long\u2010term moderate ND and persistent\u2010severe ND trajectories after ischemic stroke.<\/jats:p>\n                  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