Cardiac Troponin-I: A Predictor of Prognosis in Subarachnoid Hemorrhage

Ramappa, Preeti; Thatai, Deepak; Coplin, William M.; Gellman, Steven; Carhuapoma, J. Ricardo; Quah, Ruth; Atkinson, Benjamin; Marsh, James D.

doi:10.1007/s12028-007-9038-7

Cited by 47 publications

(51 citation statements)

References 19 publications

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“…The incidence of cardiac troponin I (cTnI) elevation after SAH has been reported between 20 and 68% ( Table 1). The mean frequency in 10 studies involving 1,612 patients was 36% [6,13,16,19,20,25,30,31,36,38], in agreement with a meta-analysis showing a prevalence of cTnI increase of 34% [66]. The incidence of regional wall motion abnormalities (RWMA), global hypokinesia, and diastolic dysfunction on echocardiography is summarized in Table 4.…”

Section: Cardiac Complications Of Sahsupporting

confidence: 77%

“…Cardiac abnormalities after SAH (e.g., RWMA, elevated cTnI and B-type natriuretic peptide levels, Q waves, ST segment depression, and abnormal T waves) are related to death, poor outcome, and delayed cerebral ischemia [66]. ECG changes or markers of myocardial injury are independently associated with neurologic outcome [20,25,66,67]. Further studies, however, are needed to establish a causal relationship between myocardial injury and neurologic outcome [67].…”

Section: Cardiac Complications Of Sahmentioning

confidence: 99%

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Cardiovascular and Pulmonary Complications of Aneurysmal Subarachnoid Hemorrhage

Bruder

Rabinstein

2011

Neurocrit Care

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Cardiopulmonary complications after aneurysmal subarachnoid hemorrhage negatively affect overall morbidity and mortality. An electronic literature search was performed for English-language articles focused on cardiopulmonary complications with subarachnoid hemorrhage published through October 2010. A total of 278 citations were identified, including 72 clinical studies. In most cases, study quality was low or very low. Cardiac injury, evidenced by an elevation in troponin levels, is reported in about one-third of patients after aneurysmal subarachnoid hemorrhage. Arrhythmias also occur in about one-third of patients after subarachnoid hemorrhage. The incidence of pulmonary complications, especially neurogenic pulmonary edema, is more difficult to establish from available literature. Cardiopulmonary complications have been linked to worsened clinical outcome, suggesting a role for cardiac monitoring and interventions.

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Section: Cardiac Complications Of Sahsupporting

confidence: 77%

Section: Cardiac Complications Of Sahmentioning

confidence: 99%

Cardiovascular and Pulmonary Complications of Aneurysmal Subarachnoid Hemorrhage

Bruder

Rabinstein

2011

Neurocrit Care

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“…17 Similarly, the release of troponin predicts poorer outcomes in patients admitted with subarachnoid hemorrhage. [18][19][20] …”

Section: Article See P 2264mentioning

confidence: 99%

Postoperative Troponin Screening

Beckman

2013

Circulation

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“…Cardiovascular biological markers like troponin I have been associated with mortality in SAH cases. 12,30,31 Although the causes of cardiac abnormalities after SAH cases are controversial, experimental data indicate that catecholamine toxicity plays a key role. [32][33][34] Although the causal links and associations between cardiac abnormalities and SAH outcomes are not clearly understood, troponin I is useful for predicting outcomes because of its association with primary brain injury and cardiac dysfunction.…”

Section: Relevance Of Abc Score Componentsmentioning

confidence: 99%

An Admission Bioclinical Score to Predict 1-Year Outcomes in Patients Undergoing Aneurysm Coiling

Degos

Apfel

Sánchez

et al. 2012

Stroke

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Background and Purpose-A number of scores were developed to predict outcomes after clipping for subarachnoidhemorrhages, yet there is no score for patients undergoing endovascular treatment. Our goal was to develop, compare, and validate a predictive score for 1-year outcomes in patients with coiled subarachnoid hemorrhage. Methods-We studied 526 patients for 1 year after intensive care unit discharge. We developed an admission bioclinical score (ABC score), which integrated biomarkers such as troponin I and S100␤, with the Glasgow Coma Scale. Using the receiver operating characteristic curve (95% CI), the ABC score was compared with the Glasgow Coma Scale, World Federation of Neurosurgical Societies score, and Fisher score in the derivation cohort and further validated in an independent cohort. Results-In the derivation cohort (from 2003-2007, nϭ368), multivariate logistic regression analysis showed that only Glasgow Coma Scale (PϽ0.001), high S100␤ (PϽ0.001), and high troponin (PϽ0.02) were independently associated with 1-year mortality. Troponin, S100␤, and Glasgow Coma Scale were thus integrated to derive the ABC score. In the derivation cohort, the ABC score reached an receiver operating characteristic curve of 0.82 (0.77-0.88, PϽ0.001) and was significantly greater than the receiver operating characteristic curves of the Glasgow Coma Scale, World Federation of Neurosurgical Societies, and Fisher scores for predicting 1-year mortality. In the validation cohort (from 2008 -2009, nϭ158), the ABC score's receiver operating characteristic curve of 0.76 (0.67-0.86, PϽ0.001) remained superior to the 3 other scores for predicting 1-year mortality. Conclusions-The ABC score improves 1-year outcome prediction at admission for patients with coiled subarachnoid hemorrhage. Our study provides large cohort-based evidence supporting integration of individual biomarkers and clinical characteristics to predict outcomes. Clinical Trial Registration-URL: www.clinicaltrials.gov. Unique identifier: NCT01357057.

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Cardiac Troponin-I: A Predictor of Prognosis in Subarachnoid Hemorrhage

Abstract: Patients with subarachnoid hemorrhage and elevated cTnI are found to have worse neurological status at admission. These patients have a worse neurological outcome and in-hospital mortality.

Cited by 47 publications

References 19 publications

Cardiovascular and Pulmonary Complications of Aneurysmal Subarachnoid Hemorrhage

Cardiovascular and Pulmonary Complications of Aneurysmal Subarachnoid Hemorrhage

Postoperative Troponin Screening

An Admission Bioclinical Score to Predict 1-Year Outcomes in Patients Undergoing Aneurysm Coiling

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