Erschienen in:
01.08.2015 | Original Article
Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality
verfasst von:
Katherine M. Duello, Jay P. Nagel, Colleen S. Thomas, Joseph L. Blackshear, William D. Freeman
Erschienen in:
Neurocritical Care
|
Ausgabe 1/2015
Einloggen, um Zugang zu erhalten
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.