Abstract
BackgroundAlthough cardiac troponin has been well established as diagnostic and prognostic makers for acute coronary heart disease, the prognostic value of elevated cardiac troponin in patients with intracerebral hemorrhage (ICH) was inconsistent and not systematically evaluated.HypothesisWe proposed the hypothesis that the practical utility of cardiac troponin levels for prediction of mortality and poor outcome in ICH patients.MethodsA total of 1004 patients with ICH were retrospectively reviewed and qualified for further analysis from June 2012 to December 2015. The patients were divided into different groups based on measurements of cardiac troponin I (cTnI) at the time of admission and the following day. Multivariate Cox proportional hazards analysis were performed to determine the independent prognostic value of the cTnI for patients in‐hospital mortality and poor outcomes, the receiver operator characteristic (ROC) analysis was performed to assess the predictive value of cTnI, ICH score, and combination of them.ResultsSerum cTnI level was an independent predictor in‐hospital mortality (positive vs negative, HR (hazard ratios) = 3.44, 95% CI (confidence interval) 1.66‐7.13, P < .001) and poor outcomes in patients with ICH (positive vs negative, HR = 6.69, 95% CI 4.25‐10.52, P < .001). Addition of cTnI to ICH score significantly improved the prognostic discrimination for both in‐hospital mortality and poor outcomes.ConclusionSerum cTnI levels may be valuable as predictor for in hospital mortality and poor outcomes and may be useful in the risk stratification of ICH during hospitalization.
Highlights
Over the past three decades, stroke burden has emerged as a publicYangchun He and Qigong Liu have contributed to this work.health problem of epidemic proportions in China.[1]
Multivariable adjusted for age, gender, history of hypertension, diabetes, hyperlipidemia, ischemic stroke, heart disease, smoking status, drinking status anti-coagulation medication, admission characteristics and in-hospital complications; Poor outcomes were defined as severe disability and mortality
We examined the utility of cardiac troponin I (cTnI) as prognostic makers in patients with intracerebral hemorrhage (ICH)
Summary
Yangchun He and Qigong Liu have contributed to this work. health problem of epidemic proportions in China.[1]. The previous study demonstrated that elevated troponin levels were associated with higher mortality following ICH.[16] Subsequently, the utility of elevated troponin levels for prediction of mortality was confirmed in surgical ICH patients,[17] but was not found to be consistently associated with in-hospital mortality in Chinese ICH patients.[18] Small sample sizes (less than 240 stroke patients) and ethnic variability probably contribute to the negative results and discrepancies This has prompted further efforts to determine whether cardiac troponin could provide valuable clinical prediction information for mortality as well as poor outcome in ICH patients with a relatively large cohort. These risk factors were define as previously reported.[19]
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