Does elevated cardiac troponin I predict worse clinical outcomes and mortality in patients with aneurysmal subarachnoid hemorrhage?
Elevated cardiac troponin I in patients with aneurysmal subarachnoid hemorrhage is a key biomarker for neurocardiogenic injury and predicts worse clinical outcomes, including increased mortality.
Many cardiopulmonary complications occur after aneurysmal subarachnoid hemorrhage. This is due to sympathetic nervous system activation which results in release of norepinephrine from myocardial sympathetic nerves. Cardiac troponin I is a marker for diagnosis of cardiac injury. Elevated levels of troponin in these patients are associated with worse clinical outcomes. PubMed was searched for literature using regular and Medical Subject Heading (MeSH) keywords for data collection. Papers published in English language involving human subjects within the last 20 years focusing on cardiac troponin elevation following subarachnoid hemorrhage were included. Systemic complications that occur after subarachnoid hemorrhage worsen the clinical outcome of patients and have negative effects on the mortality and morbidity of these patients. Cardiac troponin I elevation is significantly associated with the severity of the stroke, poor neurological status, longer ICU stay, and death. Cardiac troponin I should be measured in patients presented with acute stroke. Hemodynamic monitoring and appropriate supportive care can improve clinical outcomes.
Zahid et al. (Sun,) studied this question.