Troponin levels help predict new-onset atrial fibrillation in ischaemic stroke patients: a retrospective study

Elevated levels of cardiac troponin I (cTnI) have been reported in acute stroke and atrial fibrillation (AF). We tested a hypothesis in which the result of an initial cTnI assay helps predict new-onset AF (NAF) early in the course of ischaemic stroke in patients with sinus rhythm on admission.

This retrospective study included all patients admitted to our unit for acute ischaemic stroke between January 2006 and December 2007 (n = 402). NAF was defined as AF discovered during cardiac monitoring in patients with sinus rhythm on admission. Elevated cTnI was defined as a value > or =0.03 microg/l.

27 (6.7%) patients had NAF. In a univariate analysis, age (70.8 in patients with NAF vs. 64.6 years in patients without NAF, respectively; p = 0.024), smoking status (3.5 vs. 25.3%; p = 0.009), total anterior circulation infarcts (18.5 vs. 5.9%; p = 0.03) and elevated cTnI levels (63.0 vs. 29.9%; p = 0.001) were associated with NAF. Stepwise logistic regression identified elevated cTnI levels (OR 4.1; 95% CI 1.81-9.33; p = 0.001)and active smoking (OR 0.11; 95% CI 0.01-0.82; p = 0.03) as independent factors for NAF.

Moderately elevated troponin levels in acute ischaemic stroke are independently associated with NAF.