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Higher Levels of Admission N-Terminal Pro-brain Natriuretic Peptide are Associated with Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage

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Abstract

Background

Delayed cerebral ischemia (DCI) greatly influences the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH). We aimed to determine whether higher levels of admission N-terminal pro-brain natriuretic peptide (NT-pro BNP) were related to neurogenic cardiac injury and predicted DCI occurrence in patients with aSAH.

Methods

We retrospectively reviewed consecutive patients with aSAH between January 2018 and April 2021 in our department. Patients with admission NT-pro BNP were included for analysis. The associations between admission NT-pro BNP levels and admission cardiac troponin T levels and electrocardiogram characteristics, as well as the incidence of DCI, were investigated.

Results

A total of 415 patients with aSAH were included, among whom DCI occurred in 53 (12.8%). The admission NT-pro BNP levels were positively correlated with the cardiac troponin T levels and were significantly higher in patients with abnormal electrocardiogram characteristics. The admission log NT-pro BNP levels were higher in patients with DCI than in those without DCI. Multivariable analysis revealed that admission log NT-pro BNP levels and modified Fisher scale were independent predictors of the incidence of DCI. Compared with the modified Fisher scale alone (area under the curve = 0.739), combining the modified Fisher scale with admission NT-pro BNP (area under the curve = 0.794) significantly improved the prediction accuracy for DCI (p < 0.001).

Conclusions

Higher admission levels of NT-pro BNP correlated with neurogenic cardiac injury and predicted the occurrence of DCI in patients with aSAH. A combination of the modified Fisher scale and admission NT-pro BNP significantly improved the prediction accuracy for DCI.

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Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China

    Guang-Dong Lu, Cheng Wang, Bin Wang, Lin-Bo Zhao & Sheng Liu

Authors
  1. Guang-Dong Lu
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  2. Cheng Wang
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  3. Bin Wang
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  4. Lin-Bo Zhao
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  5. Sheng Liu
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Contributions

GDL was responsible for the conception and design, acquisition of data, analysis/interpretation of data, drafting of the initial article, revising the article, and formalizing the final draft. CW was responsible for the conception and design, acquisition of data, analysis/interpretation of data, and revising the article. BW was responsible for the acquisition of data, analysis/interpretation of data, and revising the article. LBZ was responsible for the conception and design and revising the article. SL was responsible for the conception and design, acquisition of data, analysis/interpretation of data, drafting of the article, and revising the article. All authors approved the final manuscript.

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Correspondence to Sheng Liu.

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Ethical approval/informed consent

Study procedures followed the guidelines of the World Medical Association Declaration of Helsinki and were approved by the Ethics Committee of our institution. For this retrospective study, formal consent was not required.

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Lu, GD., Wang, C., Wang, B. et al. Higher Levels of Admission N-Terminal Pro-brain Natriuretic Peptide are Associated with Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage. Neurocrit Care 38, 52–59 (2023). https://doi.org/10.1007/s12028-022-01556-6

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  • DOI: https://doi.org/10.1007/s12028-022-01556-6

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