Risk factors for cardiac injury in patients with ischaemic stroke: a retrospective analysis
Hui Tang1, Mengyuan Li2, Zhi Liu1
1Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China.
Insights
This study found that Glasgow Coma Scale scores and blood urea nitrogen levels are not independent predictors of cardiac injury in ischemic stroke patients. Early risk identification and monitoring are crucial for improving patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- Cardiac injury (CI) is a concern in patients with ischemic stroke (IS).
- Identifying independent risk factors for CI is crucial for timely intervention.
- Previous studies suggest associations, but independent predictors require clarification.
Purpose of the Study:
- To identify independent risk factors for cardiac injury (CI) in patients with ischemic stroke (IS).
- To provide evidence for early screening and intervention strategies for CI in IS patients.
Main Methods:
- A single-center retrospective study analyzed 393 hospitalized IS patients.
- Patients were classified into CI and non-CI groups based on cardiac biomarkers and ECG/echocardiographic findings.
- Multivariate logistic regression was used to identify independent risk factors for CI.
Main Results:
- Univariate analysis showed significant differences in age, cardiac biomarkers, inflammatory markers, renal function, coagulation markers, and comorbidities between groups.
- Multivariate analysis revealed that Glasgow Coma Scale scores and blood urea nitrogen levels were not statistically significant independent predictors of CI in IS patients.
- 100 out of 393 patients experienced cardiac injury.
Conclusions:
- Glasgow Coma Scale scores and blood urea nitrogen levels, while associated, are not independent predictors of cardiac injury in ischemic stroke.
- A clear operational definition of CI is essential for consistent diagnosis and early risk identification.
- Enhanced screening, monitoring, and biomarker evaluation are vital for optimizing early management and improving outcomes in IS patients with potential CI.
Objective:
To identify independent risk factors for cardiac injury (CI) in patients with ischaemic stroke (IS) through a retrospective analysis, providing evidence for early screening and intervention strategies.
Methods:
A single-center retrospective study was conducted among hospitalized patients with IS, who were classified into CI and non-CI groups. CI was defined as elevation of one or more cardiac biomarkers (cTnI/T, CK-MB, or BNP) above the upper reference limit, with concurrent ECG or echocardiographic abnormalities. Clinical characteristics, laboratory parameters, and prognostic variables were analyzed using univariate methods (chi-square test, t-test, or Mann-Whitney U test), followed by multivariate logistic regression to identify independent risk factors. Odds ratios (ORs) and 95% confidence intervals were then calculated.
Results:
Across 393 patients with IS (100 with CI and 293 without CI), univariate analysis identified significant differences in multiple parameters, including age, vital signs, cardiac biomarkers (BNP, CK-MB, cardiac troponin I), inflammatory markers (hs-CRP, LDH), renal function (BUN, creatinine), coagulation markers (D-dimer), and comorbidities (atrial fibrillation, coronary heart disease, heart failure) between the groups (p < 0.05). However, after adjusting for these potential confounders in multivariate logistic regression analysis, neither Glasgow Coma Scale (GCS) scores nor blood urea nitrogen (BUN) levels remained statistically significant independent predictors of CI in patients with IS (p > 0.05).
Conclusion:
Although GCS scores and BUN levels may be associated with CI in patients with IS, a clear operational definition of CI is essential for diagnostic consistency and early risk identification. Enhanced screening and monitoring of high-risk patients, combined with clinical and biomarker evaluation, are essential for optimizing early management strategies and improving outcomes.
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