Abstract
This study investigated the relationship between increased brain natriuretic peptide (BNP) levels following aneurysm rupture and the incidence of major adverse cardiac events (MACE), perioperative complications, and long-term neurological outcomes. We included patients with aneurysmal subarachnoid hemorrhage within 72 hours of bleeding, collecting comprehensive clinical data. Participants were divided into 2 groups based on initial serum BNP levels: elevated (>100 pg/mL) and non-elevated (≤100 pg/mL). To mitigate bias, propensity score matching was employed to balance statistically significant variables. Follow-up assessments focused on in-hospital complications, MACE, and neurological outcomes. A total of 213 patients were analyzed, with an average age of 57.4 ± 12.1 years; 61.5% were women. The average follow-up duration was 34.3 months, with hypertension and coronary heart disease as common histories. After propensity score matching, the elevated BNP group showed higher rates of myocardial infarction (13.3% vs 4.0%, P = .001), acute heart failure (25.3% vs 4.0%, P = .042), delayed cerebral ischemia (25.3% vs 10.7%, P = .032), and hydrocephalus (13.3% vs 1.3%, P = .009). However, there was no significant difference in MACE between groups during follow-up. Logistic regression identified admission BNP as an independent risk factor for MACE (OR: 4.029, 95% CI: 1.753-9.262, P = .001), myocardial infarction (OR: 4.405, P = .038), heart failure (OR: 8.420, P = .002), delayed cerebral ischemia (OR: 3.449, P = .013), and hydrocephalus (OR: 13.726, P = .020). Elevated BNP levels after intracranial aneurysm rupture are associated with MACE, delayed cerebral ischemia, and hydrocephalus during hospitalization, but not with neurological status or MACE at discharge and follow-up.