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Elevated BNP is associated with vasospasm-independent cerebral infarction following aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  21479679     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Elevated levels of B-type natriuretic peptide (BNP) have been associated with cardiac dysfunction and adverse neurological outcomes after subarachnoid hemorrhage (SAH). We sought to determine whether elevated levels of BNP are independently associated with radiographic cerebral infarction after SAH.
METHODS: Plasma BNP levels were measured after admission, a mean of 5.5 ± 3.0 days after SAH onset. Cerebral infarction was determined by retrospective review of computerized tomography (CT) scans. Cerebral vasospasm was confirmed by the presence of vascular narrowing on cerebral angiogram. The association between BNP and cerebral infarction was quantified using multivariable logistic regression and reverse stepwise elimination of clinical covariates. A stratified analysis was performed to quantify the association between BNP levels and infarction in patients with and without angiographic vasospasm.
RESULTS: BNP levels were measured from 119 subjects. The median BNP level was 105 pg/ml (interquartile range 37-275 pg/ml). In our multivariable model, the top quartile of BNP levels (≥ 276 pg/ml) were associated with an increased odds of cerebral infarction (OR 4.2, P = 0.009). The stratified analysis showed that the association between BNP and infarction was strongest in patients without angiographic vasospasm (OR 7.8, P = 0.006).
CONCLUSIONS: Elevated levels of BNP are strongly and independently associated with cerebral infarction, and the association is most pronounced in patients without angiographic vasospasm. These results provide further evidence that other mechanisms can contribute to infarction, and BNP may be a useful biomarker in detecting patients at risk for adverse outcomes without large vessel vasospasm.
Pam R Taub; Jeremy D Fields; Alan H B Wu; Jacob C Miss; Michael T Lawton; Wade S Smith; William L Young; Jonathan G Zaroff; Nerissa U Ko
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurocritical care     Volume:  15     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2012-01-19     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  13-8     Citation Subset:  IM    
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MeSH Terms
Biological Markers / blood
Cerebral Infarction / blood*,  etiology,  radiography*
Cohort Studies
Middle Aged
Natriuretic Peptide, Brain / blood*
Subarachnoid Hemorrhage / blood*,  complications,  radiography
Tomography, X-Ray Computed
Vasospasm, Intracranial / blood*,  etiology,  radiography
Grant Support
1R21 NS050551-01/NS/NINDS NIH HHS; K02 NS060892/NS/NINDS NIH HHS; K02 NS060892-04/NS/NINDS NIH HHS; K02 NS60892/NS/NINDS NIH HHS; K23 HL04054-01A1/HL/NHLBI NIH HHS; K23 NS044014/NS/NINDS NIH HHS
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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