虚血性脳卒中患者における心障害のリスク因子：後ろ向き分析

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.

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.

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).

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.