Characteristics of elevated cardiac troponin I in patients with acute ischemic stroke
Yu-Xia Cui1,2,3, Hui Ren1,2,3, Chong-You Lee1,2,3
1Department of Cardiology, Peking University People's Hospital, Beijing, China.
Insights
Elevated cardiac troponin I (cTnI) in acute ischemic stroke patients indicates a higher risk of poor outcomes. This finding highlights the prognostic value of cTnI in stroke care.
Area of Science:
- Cardiology
- Neurology
- Biomarkers
Background:
- Cardiac troponin I (cTnI) elevation is a known indicator of myocardial injury.
- Its prognostic significance in acute ischemic stroke (AIS) requires further elucidation.
Purpose of the Study:
- To investigate the prognostic characteristics of elevated cTnI in patients diagnosed with AIS.
- To identify risk factors and clinical outcomes associated with cTnI elevation in AIS.
Main Methods:
- A retrospective study of 248 patients (178 with AIS) treated between 2013-2015.
- Comparison of demographic data, cTnI levels, and clinical outcomes between AIS patients with and without cTnI elevation.
- Logistic regression analysis to determine risk factors for elevated cTnI in AIS.
Main Results:
- 18.5% of AIS patients exhibited elevated cTnI (> 0.034 ng/mL).
- Elevated cTnI was associated with older age, hypertension history, higher inflammatory markers, reduced renal function, increased D-dimer, higher NIH stroke scores, and lower left ventricular ejection fraction.
- Elevated cTnI correlated with more frequent major cardiovascular events during hospitalization.
Conclusions:
- Elevated cTnI in AIS patients is linked to a poorer short-term prognosis.
- cTnI elevation serves as a significant prognostic marker in acute ischemic stroke management.
Objective:
To study prognostic characteristics of cardiac troponin I (cTnI) elevation in acute ischemic stroke.
Methods:
We retrospectively studied patients (n = 248) with acute ischemic stroke, acute ST-segment elevation myocardial infarction, and acute non-ST-elevation myocardial infarction who were treated between January 2013 and October 2015. Baseline demographic data and changes in cTnI levels among these three groups were compared. Patients with acute ischemic stroke were assigned to either the cTnI elevation group (cTnI > 0.034 ng/mL) or the no cTnI elevation group (cTnI ≤ 0.034 ng/mL). Logistic regression analysis was used to identify risk factors associated with elevated serum cTnI in patients with acute ischemic stroke. Moreover, the duration of hospital stay and incidence of major cardiovascular outcomes were compared in patients with acute ischemic stroke, with or without elevated cTnI.
Results:
In this study population of patients with acute ischemic stroke (n = 178), acute ST-segment elevation myocardial infarction (n = 35), and acute non-ST-elevation myocardial infarction (n = 35), patients with acute ischemic stroke with elevated cTnI comprised 18.5% of subjects. Patients with elevated cTnI were older and more likely to have a history of hypertension. In addition, these patients had higher levels of inflammatory markers, reduced renal functions, increased D-dimer levels, higher NIH stroke scores, and lower left ventricular ejection fractions. Logistic regression analysis showed that both percentage of neutrophil and NIH stroke scores were elevated; estimated glomerular filtration rate and left ventricular ejection fraction were decreased in patients with acute ischemic stroke who had elevated cTnI, and they had more frequent major cardiovascular events during hospital stay.
Conclusion:
Elevated cTnI detected in patients with acute ischemic stroke, indicated a greater likelihood of poor short-term prognosis during hospital stay.
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