J Korean Soc Emerg Med.  2000 Dec;11(4):506-515.

Clinical Significance of Myocardial Injuries in Patients with Nontraumatic Intracraninal Hemorrhage

• Kang GH
• Hwang SO
• Lee KH
• Cho JH
• Kim SW
• Moon JB
• Park HS
• Lee SY
• Lee SS
• Kim HJ

Abstract

OBJECTIVE
The aim of this study was to investigate the clinical significance of myocardial injuries in patients with nontraumatic intracranial hemorrhage by identifying the occurrence of myocardial injury and defining its correlation with subsequent cardiovascular events.
SUBJECTS AND METHODS
One hundred twenty-four patients with nontraumatic intracraninal hemorrhage presented to the emergency department within six hours from onset of symptoms were enrolled. Brain CT, serial electrocardiography, and echocardiography were done at the emergency center. Blood samples for troponin I and creatine kinase(CK)-MB were drawn immediately and eight hours after admission. Troponin I and CK-MB were measured using a chemiluminescent immunoassay, respectively.
RESULTS
Electrocardiographic and echocardiography abnormalities were found in 65 cases(52.4%) and 21 cases(17%), respectively. Serum troponin I and creatine kinase-MB were increased in 35 cases (28.2%) and in 58 cases(46.8%), respectively. Abnormal findings of echocardiography and ECG, as well as elevated levels of serum troponin I and creatine kinase-MB, were associated with an increased risk of cardiovascular event and survival. Logistic regression analysis revealed that an abnormal echcocardiographic finding and elevation of serum troponin I were factors associated with the occurrence an adverse cardiovascular event and that electrocardiographic abnormalities and initial mental status were factors associated with poor prognosis.
CONCLUSION
This study reveals that actual myocardial injury develops in a significant proportion of patients with nontraumatic intracranial hemorrhage and that the development of the myocardial injury is associated with an adverse cardiovascular event that occurs during admission.

MeSH Terms

Brain
Creatine
Echocardiography
Electrocardiography
Emergencies
Emergency Service, Hospital
Hemorrhage*
Humans
Immunoassay
Intracranial Hemorrhages
Logistic Models
Prognosis
Troponin I
Creatine
Troponin I