Increased High-Sensitivity Troponin-T Levels Are Associated with Mortality After Ischemic Stroke.

Abstract

Biomarkers for diagnosis, treatment, and outcome prediction after stroke are lacking. Therefore, we aimed to evaluate the association between increased serum troponin, stroke severity, and mortality. Unselected patients with acute ischemic stroke assessed for troponin levels were included over the span of 1 year. Risk-factor profile, stroke etiology, stroke severity, and mortality during acute admission were recorded. The study included 212 patients, and 35 had increased troponin levels. Elevated troponin levels were associated with older age (82.1 ± 10.7 vs. 72.2 ± 12.6, p < 0.001), poor kidney function (calculated GFR 58.7 ± 29.8 vs. 82.7 ± 28.4, p < 0.001), and known ischemic heart disease (51.4% vs. 33.9%, p = 0.049). Patients with increased troponin had increased stroke severity on admission (National Institutes of Health Stroke Scale (NIHSS) 16.0 ± 9.4 vs. 10.4 ± 8.0, p < 0.001). This association remained significant after multivariate analysis but was nonlinear. Mortality rates were significantly higher in patients with increased troponin (37.1 vs. 5.6%, p < 0.001). On multivariate analysis, elevated troponin (odds ratio [OR] 22.57, 95% CI 4.4-116.6), absence of ischemic heart disease (OR 10.3, 95% CI 1.8-57.6), and admission NIHSS score (OR 1.59 for every 5 points, 95% CI 1.1-2.4) were associated with mortality. This study indicates that elevated troponin is an independent marker for severe deficits on presentation and for mortality in stroke patients.