The clinical prognostic significance of hs-cTnT elevation in patients with acute ischemic stroke

Lanying He,Weiwei Dong,Jian Wang

doi:10.1186/s12883-018-1121-5

Abstract

BackgroundCardiac autonomic dysfunction caused by ischemic stroke might lead to an adverse outcome. Elevated high sensitivity cardiac troponin (hs-cTnT) is a marker of cardiac disease, it can elevate in acute stroke patients. The aim of the present study was to investigate association between serum hs-cTnT with prognosis among patients with acute ischemic stroke.MethodsFive hundred and sixteen patients (mean age 66.19 ± 10.11) with acute ischemic stroke underwent a comprehensive clinical investigation and serum hs-cTnT activity test. All patients were followed up for 3 months. The prognosis was death or major disability (modified Rankin Scale score ≥ 3) at 3 months after acute ischemic stroke.Results22.87% (118/516) of patients had serum hs-cTnT elevation (≥14 ng/l). Compared with normal hs-TnT group, the incidence of insular stroke (adjusted odds ratio, 2.84; 95% confidence interval, 1.48–4.17; P = 0.001) were more likely in patients with hs-cTnT elevation. In fully adjusted models, there was an association between serum hs-cTnT elevation and death (adjusted odds ratio, 3.14; 95% confidence interval, 1.16–8.49; P = 0.02) and major disability(adjusted odds ratio, 2.07; 95% confidence interval, 1.04–4.51; P = 0.04), and composite outcome(adjusted odds ratio,2.22;95% confidence interval,1.10–4.48; P = 0.03).ConclusionsHigher levels of serum hs-cTnT were independently associated with increased risk of death or major disability after stroke onset, suggesting that serum hs-cTnT may have prognostic value in poor outcomes of ischemic stroke.

Highlights

Cardiac autonomic dysfunction caused by ischemic stroke might lead to an adverse outcome
Insular stroke associated with High sensitivity cardiac troponin (hs-cTnT) elevation
These results suggested this association was independent of established risk factors, including age, and baseline NIHSS score, and increased serum hs-cTnT elevation could be an independent risk factor of poor outcomes and have prognostic value for death or major disability among patients with acute ischemic stroke

Summary

Introduction

Cardiac autonomic dysfunction caused by ischemic stroke might lead to an adverse outcome. Elevated high sensitivity cardiac troponin (hs-cTnT) is a marker of cardiac disease, it can elevate in acute stroke patients. The aim of the present study was to investigate association between serum hs-cTnT with prognosis among patients with acute ischemic stroke. Stroke is an important contributor to death and major disability. Ischemic stroke is the most common subtype of stroke. Autonomic dysfunction is a frequent in stroke patients. Studies showed that cardiac autonomic dysfunction caused by ischemic stroke might lead to an adverse outcome. Cardiac comorbidities account for almost 20% of deaths after ischemic stroke, appropriate preventive or therapeutic measures can be taken if the patient with acute stroke at risk of myocardial injury could be identified at the time of admission.

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