Background: Intracranial hemorrhage (ICH) is often associated with cardiac events. Twelve-lead electrocardiography (ECG) and transthoracic echocardiography are essential diagnostic tools for preoperative risk assessment. B-type natriuretic peptide (BNP) is a well-known predictor of cardiac outcome in various clinical settings. This study examined whether BNP levels on admission are associated with in-hospital cardiac events among ICH patients.
Method: This prospective study enrolled 77 ICH patients who were admitted to this hospital for emergency neurosurgery. On admission, BNP levels, 12-lead ECG and transthoracic echocardiography were carried out for all patients. These patients were divided into two groups: Group I included 19 patients (10 men and 9 women) having 24 in-hospital cardiac events (mean age of 57 ± 15 years); Group II included 57 patients (29 men, mean age of 71 ± 11 years) without cardiac events.
Results: Admission BNP levels of Group I patients were significantly higher than those of Group II patients (683.8 ± 1,043.8 pg/ml vs 168.5 ± 173.5 pg/ml, p = 0.001). In multivariate analysis, BNP levels and T-wave inversion are independent predictors of in-hospital cardiac events. A cutoff value of BNP levels (156.6 pg/ml) predicted in-hospital cardiac events in ICH patients with 80 % sensitivity and 66 % specificity.
Conclusions: Serum BNP levels and electrocardiographic T-wave inversion on admission are independent predictors of in-hospital cardiac events in patients with ICH who undergo emergency neurosurgery.