Early Elevated Troponin Levels After Ischemic Stroke Suggests a Cardioembolic Source

Area of Science:

• Cardiology
• Neurology
• Biomarkers

Background:

• Elevated cardiac troponin indicates cardiac disease and is linked to embolic stroke risk.
• Cardiac troponin's role in acute ischemic stroke subtypes requires further investigation.

Purpose of the Study:

• To determine if early elevated troponin levels are more prevalent in embolic stroke subtypes compared to non-embolic subtypes.
• To investigate the association between troponin positivity and specific embolic stroke classifications.

Main Methods:

• Analysis of a prospective ischemic stroke database over 18 months.
• Definition of positive troponin as ≥0.1 ng/mL and intermediate as ≥0.06 ng/mL and <0.1 ng/mL.
• Use of unadjusted and adjusted regression models, controlling for demographics, clinical characteristics, cardiac variables, and infarct location.

Main Results:

• 10.0% of 1129 patients had positive troponin levels.
• Troponin positivity was significantly associated with embolic stroke of unknown source (aOR, 4.46; P=0.003).
• Troponin positivity was also significantly associated with cardioembolic stroke (OR, 5.00; P=0.002).

Conclusions:

• Early positive troponin after ischemic stroke may independently indicate a cardiac embolic source.
• Further research with high-sensitivity troponin assays is needed.
• Optimal secondary prevention strategies for patients with embolic stroke and positive troponin require testing.