Association between Cardiac Troponin-I and Short-Term Outcomes in Subarachnoid Hemorrhage: A Prospective Observational Study
Md. Aminul Islam *
Department of Medicine, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Muhammad Robiul Hoque
Department of Paediatric Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Md. Mazharul Islam
Department of Neurophysiology, National institute of Neuroscience and Hospital, Dhaka, Bangladesh.
Md Ashaduzzaman
Department of Paediatric Neurology and Development, Shaheed Ziaur Rahman Medical College and Hospital, Bogura, Bangladesh.
Md. Hasan Ali
Department of Neurophysiology, National Institute of Neuroscience and Hospital, Dhaka, Bangladesh.
Kazi Irfan Subhan
Department of Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
Shuvro Saha
Department of Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Subarachnoid hemorrhage (SAH) is a catastrophic neurological event, which is associated with significant medical complications. Cardiac troponin I(cTnI) release occurs frequently after SAH and has been associated with a neurogenic form of myocardial injury. The aim of the study was to find out the association of serum cardiac troponin I and short term outcome in patients with Subarachnoid haemorrhage.
Methods: This prospective observational study was carried out in the department of Neurology, Neurosurgery and Medicine in Dhaka Medical College & Hospital, Dhaka, Bangladesh over a period of two years starting from July, 2022 to June, 2024. A total of 95 patients suffering from subarachnoid haemorrhage confirmed by CT scan of head were included in this study. The patients were divided in to the Group I= SAH with cTnI <0.3 ng/ml; n=47 and Group II= SAH with cTnI ³ 0.3 ng/ml; n=48 groups, according to Troponin I level measured within 72 hours after the incident.
Results: The mean age of the study population in Group I and Group II were 50.51±9.13 vs 57.58±10.63 years (p=0.001). The mean GCS in Group I and Group II were 13.85±1.41 vs 12.20±2.68 (p=0.001). The mean Hunt and Hess scale were 2.55±0.65 vs 3.15±0.77 (p=0.001) in Group I and Group II respectively. The mean serum cardiac troponin I was 0.12±0.05 vs 0.65±0.36 (p=0.001) in Group I and Group II and 0.25±0.22 in independent, 0.35±0.24 dependent and 0.86±0.45 in death (p=0.001). Majority (83.0%) patients had good outcome in serum cardiac troponin I <0.30 and 57.4% in serum cardiac troponin I ³0.30. The difference of was statistically significant between two groups (OR=3.79; 95%CI 1.34-11.00, p<0.05).
Conclusion: Measurements of serum troponin I reveal a higher incidence of myocardial injury in patients with SAH. Raised serum cardiac troponin I is associated with more severe neurological injury.
Keywords: Troponin I, short term outcome, subarachnoid haemorrhage, cardiac troponin