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Cardiac Biomarkers Predict Large Vessel Occlusion in Patients with Ischemic Stroke

Andrew Chang1, Brittany Ricci1, Brian Mac Grory1

  • 1Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 23, 2019
PubMed

Insights

Elevated cardiac troponin levels are linked to large vessel occlusion in acute ischemic stroke patients. This finding may help refine stroke prevention strategies for individuals with large vessel occlusion.

Area of Science:

  • Neurology
  • Cardiology
  • Medical Diagnostics

Background:

  • Cardiac biomarkers can offer insights into stroke mechanisms.
  • Limited data exists on the association between cardiac biomarkers and acute ischemic stroke (AIS) due to large vessel occlusion (LVO).

Purpose of the Study:

  • To investigate the association between cardiac biomarkers, specifically cardiac troponin and left atrial diameter (LAD), and the presence of LVO in AIS patients.

Main Methods:

  • Prospective AIS database analysis of 1234 patients over 18 months.
  • LVO defined as proximal occlusion in major cerebral arteries.
  • Multivariable models assessed associations between troponin, LAD, and LVO, adjusting for demographic and risk factors, including atrial fibrillation (AF).

Main Results:

  • An association was found between elevated troponin and LVO (adjusted OR 1.69 [1.08-2.63], P=.022), persisting after AF adjustment (adjusted OR 1.60 [1.02-2.53], P=.043).
  • Left atrial diameter (LAD) showed an association with LVO (adjusted OR per mm 1.03 [1.01-1.05], P=.013), which was not significant after AF adjustment (adjusted OR 1.01 [0.99-1.04], P=.346).

Conclusions:

  • Serum troponin levels are associated with acute LVO in ischemic stroke patients.
  • Further prospective studies are needed to confirm this association and explore anticoagulation's role in preventing recurrent embolism.
Abstract

Keywords:
Troponincardiac biomarkerslarge vessel occlusionleft atrial enlargementstroke

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