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Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality

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Abstract

Background

Troponin and brain natriuretic peptide (BNP) levels are predictors of mortality following subarachnoid hemorrhage (SAH). Prior studies used strict cutoffs for BNP elevation; however, normal levels of BNP are increased in older persons and women. We explored the association of troponin elevation and BNP elevation adjusted for sex and age with 30-day mortality.

Methods

In this retrospective cohort study of patients with SAH, collected data included peak troponin T and BNP levels. Mortality data were obtained from inpatient mortality data and available records. Troponin T elevation was defined as more than 0.10 ng/mL; BNP elevation was defined as greater than the 95th percentile reference limit by age and sex for patients without cardiovascular disease. Associations of elevated troponin T and BNP were estimated from a log-binomial regression model reporting relative risks (RRs), 95 % CIs, and P values; missing data were imputed with the sample median or most frequent category.

Results

This study included 175 SAH patients. In single-variable analysis, peak troponin T level greater than 0.10 ng/mL was associated with increased risk in 30-day mortality (RR 4.38; 95 % CI 2.43–7.89; P < .001); there was no association with elevated peak BNP adjusted for age and sex (RR 1.13; 95 % CI 0.55–2.35; P = .74). There was no evidence suggesting that the combination of elevated peak BNP and elevated peak troponin increased the risk of 30-day mortality.

Conclusions

Elevated troponin was an independent predictor of 30-day mortality following SAH; however, when adjusted for age and sex, elevations in BNP did not have this association.

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Abbreviations

BNP:

Brain natriuretic peptide

GCS:

Glasgow Coma Scale

RR:

Relative risk

SAH:

Subarachnoid hemorrhage

WFNS:

World Federation of Neurological Surgeons

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL, USA

    Katherine M. Duello & Joseph L. Blackshear

  2. Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA

    Colleen S. Thomas

  3. Emergency Department, Mayo Clinic, Jacksonville, FL, USA

    Jay P. Nagel

  4. Department of Neurology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA

    William D. Freeman

  5. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA

    William D. Freeman

  6. Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA

    William D. Freeman

Authors
  1. Katherine M. Duello
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  2. Jay P. Nagel
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  3. Colleen S. Thomas
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  4. Joseph L. Blackshear
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  5. William D. Freeman
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Corresponding author

Correspondence to William D. Freeman.

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Duello, K.M., Nagel, J.P., Thomas, C.S. et al. Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality. Neurocrit Care 23, 59–65 (2015). https://doi.org/10.1007/s12028-014-0105-6

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  • DOI: https://doi.org/10.1007/s12028-014-0105-6

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