Abstract 10328: Brain Natriuretic Peptide as a Predictor of Outcome for Non-traumatic Subarachnoid Hemorrhage
Background: Age and the degree of consciousness impairment at onset in patients (pts) with non-traumatic subarachnoid hemorrhage (NSH) have been found to be closely related to prognosis. The impact of cardiac abnormalities after aneurysmal subarachnoid hemorrhage (SAH) remains unclear. We investigated whether ECG abnormalities, myocardial damage, sympathetic nervous activity or echocardiographic wall motion abnormalities (WMA) could provide additional risk stratification in patients with NSH.
Methods: We prospectively studied 92 pts (59 women, mean age 62±16 years) without a history of heart disease. Neurological grade (Hunt and Kosnik grade) and clinical factors were evaluated. A standard 12-lead ECG, echocardiography and blood samples for creatine kinase (CK) MB isoenzyme, brain natriuretic peptide (BNP), troponin-I (Tn-I) and plasma norepinephrine (pNE) levels were obtained within 24 hours after the onset of NSH. ECG abnormalities were defined as abnormal Q wave, ST elevation, giant T-wave inversion or QT prolongation.
Results: Ten of 92 patients (11%) died in the first month after the onset of NSH. Death was significantly associated with age (p=0.0011), neurological grade (p=0.0003) high BNP (p<0.0001), Tn-I (p=0.0111) and pNE (p=0.0111), while ECG abnormalities and WMA were not significantly associated. Neurological grade (p=0.0170) and BNP (p=0.0066, hazard ratio 1.28 for each 10pg/ml increase in BNP, 95%CI 1.007 to 1.043) were independently associated with death.
Conclusion: Brain natriuretic peptide may provide additional risk stratification in the acute phase of patients with non-traumatic subarachnoid hemorrhage.
- © 2013 by American Heart Association, Inc.