Elevated Baseline High-Sensitivity Cardiac Troponin T Associates with Early Neurological Deterioration After...

High-sensitivity cardiac troponin T(hs-cTnT), a sensitive serum biomarker for myocardial injury, was well observed in predicting poor long-term outcomes after acute ischemic stroke (AIS). However, there's limited evidence of its value in short-term outcomes and continuous conflicts in understanding the potential mechanisms. This study aimed to explore the association between hs-cTnT and early neurological deterioration (END) of AIS patients treated with mechanical thrombectomy (MT). This single-center cohort study included AIS patients undergoing MT within 24 hours of onset. Patients were divided into elevated and normal hs-cTnT groups. The outcomes were END, in-hospital mortality, modified Rankin Scale score of 3-6/2-6 at 90 days, and 90-day mortality. The associations between hs-cTnT and outcomes were evaluated with logistic regression analysis. Restricted cubic spline (RCS) analysis was used to analyze the correlation between the absolute change of hs-cTnT(Δhs-cTnT) and END. A total of 271 patients were enrolled, with a mean age of 70(±11) years, and 118 (43.5%) patients had elevated hs-cTnT. After adjusting covariates, elevated hs-cTnT was independently associated with a higher likelihood of END (adjusted OR 2.20, 95% CI: 1.12 to 4.33, p = 0.023). For END subgroups, elevated hs-cTnT was associated with a higher risk of brain-related END (adjusted OR: 2.36, 95% CI: 1.16 to 4.80, p = 0.018), but not significantly with cardiac-related END (OR: 1.97, 95% CI: 0.32 to 11.98, p = 0.462). RCS analysis showed an S-shaped relationship between Δhs-cTnT and the incidence of END. In conclusion, elevated hs-cTnT appears to be associated with brain- but not cardiac-related END in AIS patients treated with MT, highlighting its potential value in reflecting ischemic brain injury rather than cardiac complications.