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

Katherine M. Duello, Jay P. Nagel, Colleen S. Thomas, Joseph L. Blackshear, William D. Freeman

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalNeurocritical Care
Volume23
Issue number1
DOIs
StatePublished - Aug 3 2015

Fingerprint

Troponin T
Brain Natriuretic Peptide
Subarachnoid Hemorrhage
Mortality
Troponin
Statistical Models
Inpatients
Cohort Studies
Cardiovascular Diseases
Retrospective Studies

Keywords

  • Brain injury
  • Brain natriuretic peptide
  • Subarachnoid hemorrhage
  • Troponin

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality. / Duello, Katherine M.; Nagel, Jay P.; Thomas, Colleen S.; Blackshear, Joseph L.; Freeman, William D.

In: Neurocritical Care, Vol. 23, No. 1, 03.08.2015, p. 59-65.

Research output: Contribution to journalArticle

Duello, Katherine M. ; Nagel, Jay P. ; Thomas, Colleen S. ; Blackshear, Joseph L. ; Freeman, William D. / Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality. In: Neurocritical Care. 2015 ; Vol. 23, No. 1. pp. 59-65.
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T1 - Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality

AU - Duello, Katherine M.

AU - Nagel, Jay P.

AU - Thomas, Colleen S.

AU - Blackshear, Joseph L.

AU - Freeman, William D.

PY - 2015/8/3

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N2 - 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.

AB - 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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KW - Brain natriuretic peptide

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KW - Troponin

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