Troponin and non-traumatic subarachnoid haemorrhage
Introduction: Subarachnoid haemorrhage (SAH) is a devastating event, with a mortality of up to 50%. Acute cardiac dysfunction is common after such an event, and it is known to have a negative impact on the outcome of these patients. Cardiac troponin release occurs frequently after SAH and represent...
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| Format: | Article |
| Language: | English |
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London Academic Publishing
2022-06-01
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| Series: | Romanian Neurosurgery |
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| Online Access: | https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/2287 |
| _version_ | 1828466869131018240 |
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| author | Raluca Stoica Diana-Gabriela Iacob Gabriel Iacob |
| author_facet | Raluca Stoica Diana-Gabriela Iacob Gabriel Iacob |
| author_sort | Raluca Stoica |
| collection | DOAJ |
| description |
Introduction: Subarachnoid haemorrhage (SAH) is a devastating event, with a mortality of up to 50%. Acute cardiac dysfunction is common after such an event, and it is known to have a negative impact on the outcome of these patients. Cardiac troponin release occurs frequently after SAH and represents an early biomarker for neurogenic cardiac dysfunction.
Objective: The present study aimed to evaluate the impact of a raised troponin value on the outcome of SAH patients.
Methods: This is a prospective observational study held between 2014-2017 at the University Emergency Hospital, Bucharest. Data on clinical admission status, high-sensitivity troponin I, ECG and echocardiographic evaluation results, ICU length of stay and in-hospital mortality rate. Statistical analysis was performed using non-parametrical Mann-Whitney and chi-square tests. The results were considered significant at p<0.05.
Results: A total of 335 consecutive patients with non-traumatic SAH were admitted during the study period. 92 of them were excluded and 243 were analyzed, 203 with aneurysmal SAH and 40 with non-aneurysmal, non-traumatic SAH. High-sensitivity troponin I reached its peak level 48 to 72 hours after SAH and was higher in patients with aneurysmal SAH. For all SAH patients, its median and peak values on days 1 and 2 were correlated with the ICU length of stay and inversely correlated with in-hospital length of stay. For the first 3 days, the median and maximum troponin values are higher in patients who died compared with those who survived and were discharged home (p-value < 0.001). Predictors of an elevated troponin on day 1 are loss of consciousness at ictus, a high Hunt and Hess and Fisher Scale grade, intraventricular haemorrhage and cerebral midline shift.
Conclusions: The release of cardiac troponin is a valuable marker of neurogenic cardiac dysfunction in the first 3 days after SAH. The study replicates other data in the literature and highlights the association between SAH severity, early troponin elevation and in-hospital death.
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| first_indexed | 2024-12-11T03:57:10Z |
| format | Article |
| id | doaj.art-d93141d9357046cea16144c17c36312b |
| institution | Directory Open Access Journal |
| issn | 1220-8841 2344-4959 |
| language | English |
| last_indexed | 2024-12-11T03:57:10Z |
| publishDate | 2022-06-01 |
| publisher | London Academic Publishing |
| record_format | Article |
| series | Romanian Neurosurgery |
| spelling | doaj.art-d93141d9357046cea16144c17c36312b2022-12-22T01:21:46ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592022-06-01362Troponin and non-traumatic subarachnoid haemorrhageRaluca StoicaDiana-Gabriela IacobGabriel Iacob Introduction: Subarachnoid haemorrhage (SAH) is a devastating event, with a mortality of up to 50%. Acute cardiac dysfunction is common after such an event, and it is known to have a negative impact on the outcome of these patients. Cardiac troponin release occurs frequently after SAH and represents an early biomarker for neurogenic cardiac dysfunction. Objective: The present study aimed to evaluate the impact of a raised troponin value on the outcome of SAH patients. Methods: This is a prospective observational study held between 2014-2017 at the University Emergency Hospital, Bucharest. Data on clinical admission status, high-sensitivity troponin I, ECG and echocardiographic evaluation results, ICU length of stay and in-hospital mortality rate. Statistical analysis was performed using non-parametrical Mann-Whitney and chi-square tests. The results were considered significant at p<0.05. Results: A total of 335 consecutive patients with non-traumatic SAH were admitted during the study period. 92 of them were excluded and 243 were analyzed, 203 with aneurysmal SAH and 40 with non-aneurysmal, non-traumatic SAH. High-sensitivity troponin I reached its peak level 48 to 72 hours after SAH and was higher in patients with aneurysmal SAH. For all SAH patients, its median and peak values on days 1 and 2 were correlated with the ICU length of stay and inversely correlated with in-hospital length of stay. For the first 3 days, the median and maximum troponin values are higher in patients who died compared with those who survived and were discharged home (p-value < 0.001). Predictors of an elevated troponin on day 1 are loss of consciousness at ictus, a high Hunt and Hess and Fisher Scale grade, intraventricular haemorrhage and cerebral midline shift. Conclusions: The release of cardiac troponin is a valuable marker of neurogenic cardiac dysfunction in the first 3 days after SAH. The study replicates other data in the literature and highlights the association between SAH severity, early troponin elevation and in-hospital death. https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/2287aneurysmal subarachnoid haemorrhagenon-aneurysmalnon-traumatic subarachnoid haemorrhagecardiac troponincardiac markersneurogenic cardiac dysfunction |
| spellingShingle | Raluca Stoica Diana-Gabriela Iacob Gabriel Iacob Troponin and non-traumatic subarachnoid haemorrhage Romanian Neurosurgery aneurysmal subarachnoid haemorrhage non-aneurysmal non-traumatic subarachnoid haemorrhage cardiac troponin cardiac markers neurogenic cardiac dysfunction |
| title | Troponin and non-traumatic subarachnoid haemorrhage |
| title_full | Troponin and non-traumatic subarachnoid haemorrhage |
| title_fullStr | Troponin and non-traumatic subarachnoid haemorrhage |
| title_full_unstemmed | Troponin and non-traumatic subarachnoid haemorrhage |
| title_short | Troponin and non-traumatic subarachnoid haemorrhage |
| title_sort | troponin and non traumatic subarachnoid haemorrhage |
| topic | aneurysmal subarachnoid haemorrhage non-aneurysmal non-traumatic subarachnoid haemorrhage cardiac troponin cardiac markers neurogenic cardiac dysfunction |
| url | https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/2287 |
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