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Cardiac troponin for predicting all-cause mortality in patients with acute ischemic stroke: a meta-analysis

Yu Fan1, Menglin Jiang1, Dandan Gong1

  • 1Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, P.R. China.

Bioscience Reports
|February 14, 2018
PubMed

Insights

Elevated cardiac troponin levels in acute ischemic stroke patients significantly increase the risk of all-cause mortality. This finding suggests cardiac troponin testing can aid in early death risk stratification for stroke patients.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Cardiac troponins are established biomarkers for cardiac injury.
  • The prognostic significance of elevated cardiac troponins in acute ischemic stroke (AIS) patients remains debated.
  • Early identification of mortality risk in AIS patients is crucial for timely intervention.

Purpose of the Study:

  • To conduct a meta-analysis investigating the association between elevated cardiac troponin and all-cause mortality in patients with AIS.
  • To determine the prognostic value of cardiac troponin elevation in predicting mortality risk following acute ischemic stroke.

Main Methods:

  • Systematic literature search of PubMed and Embase databases up to April 2017.
  • Inclusion of observational studies reporting on baseline cardiac troponin-T (cTnT) or troponin-I (cTnI) elevation and all-cause mortality in AIS patients.
  • Pooled analysis using a random-effects model to calculate adjusted risk ratios (RR) and 95% confidence intervals (CI).

Main Results:

  • Twelve studies comprising 7905 AIS patients met the inclusion criteria.
  • Elevated cardiac troponin was significantly associated with increased all-cause mortality (RR: 2.53; 95% CI: 1.83-3.50).
  • The association was stronger for in-hospital mortality (RR: 3.54; 95% CI: 2.09-5.98), with both cTnT and cTnI showing similar prognostic value.

Conclusions:

  • Baseline elevation of cardiac troponin (cTnT or cTnI) independently predicts a higher risk of all-cause mortality in acute ischemic stroke patients.
  • Cardiac troponin determination upon admission may facilitate early risk stratification for mortality in this population.
  • These findings underscore the importance of cardiac biomarker assessment in stroke management.

Keywords:
acute ischemic strokeall-cause mortalitycardiac troponinmeta-analysis

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