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Highly sensitive troponin T in patients with acute ischemic stroke

J K Jensen1, T Ueland, P Aukrust

  • 1Department of Cardiology, Odense University Hospital, Odense, Denmark. jesperkjensen@dadlnet.dk

European Neurology
|October 12, 2012
PubMed

Insights

Highly sensitive troponin T (hsTnT) is frequently elevated in acute ischemic stroke patients. However, hsTnT did not predict long-term mortality in this population, even when initial troponin assays were normal.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarker Research

Background:

  • Newly developed troponin assays show improved diagnostic and prognostic capabilities in acute coronary syndrome (ACS).
  • The utility of highly sensitive troponin (hsTnT) in acute ischemic stroke patients remains unevaluated.
  • Conventional troponin assays may not detect subtle cardiac marker elevations in stroke patients.

Purpose of the Study:

  • To evaluate the diagnostic and prognostic performance of highly sensitive troponin T (hsTnT) in patients with acute ischemic stroke.
  • To determine if hsTnT levels predict long-term mortality in acute ischemic stroke patients.
  • To assess the prevalence of elevated hsTnT in acute ischemic stroke patients with normal conventional troponin assays.

Main Methods:

  • Highly sensitive troponin T (hsTnT) was measured daily for 4 days in 193 acute ischemic stroke patients.
  • Patients were selected if they had normal results with a fourth-generation troponin T assay and no overt ACS or atrial fibrillation.
  • Follow-up for all-cause and cardiovascular mortality was conducted over 47 months.

Main Results:

  • 33.7% of patients exhibited hsTnT levels >14 ng/l upon admission.
  • Elevated hsTnT was associated with older age, decreased hemoglobin, and increased creatinine, NT-proBNP, and CRP levels.
  • After adjusting for stroke severity and other clinical factors, hsTnT was not a significant predictor of long-term mortality.

Conclusions:

  • Elevated hsTnT levels are common in acute ischemic stroke patients, even with normal conventional troponin assays.
  • hsTnT did not offer additional prognostic value for long-term mortality in this patient group.
  • Further research may be needed to clarify the role of hsTnT in acute ischemic stroke management.
Abstract

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