Elevation of high‐sensitivity cardiac troponin T at admission is associated with increased 3‐month mortality in acute ischemic stroke patients treated with thrombolysis

Abstract

Background Elevated levels of cardiac troponin T (cTnT) have been associated with unfavorable outcomes in cardiac patients. However, no studies, to date, have discussed the prognostic value of high‐sensitivity cTnT (hs‐cTnT) in thrombolyzed patients with acute ischemic stroke (AIS). Hypothesis We hypothesized that elevated levels of hs‐cTnT would be associated with poorer clinical outcomes in AIS patients treated with intravenous tissue‐type plasminogen activator (IV tPA). Methods From January 2017 to February 2018, a total of 241 AIS patients treated with IV tPA within 4.5 hours of onset were recruited. On admission, patients were stratified into either normal or elevated hs‐cTnT groups according to a cutoff value of 14 ng/L. Multivariable logistic regression analyses were conducted to identify determinants of hs‐cTnT elevation and to detect whether elevated hs‐cTnT was associated with disability and/or mortality. Results In multivariable regression analysis, older age (P < .001) and stroke etiology (P = .024) were significantly associated with elevated hs‐cTnT levels. After adjusting for demographic and clinical characteristics, hs‐cTnT elevation was still significantly associated with 14‐day major disability (modified Rankin Scale (mRS) 3‐5, model 1, P = .019, odds ratio [OR] 2.677; model 2, P = .015, OR 2.834), 14‐day composite unfavorable outcome (mRS 3‐6, model 1, P = .005, OR 3.525; model 2, P = .003, OR 3.976), 30‐day mortality (P = .049, OR 4.545) and 90‐day mortality (P = .049, OR 3.835). Conclusions Elevation of hs‐cTnT at admission is associated with an increased risk of 90‐day mortality in AIS patients treated with IV tPA.

Elevated troponin I levels on admission predict long-term mortality in patients with acute cerebral infarction following thrombolysis

“…The ascending risk was maintained during the entire 5-year follow-up period. The ascending risk of mortality in patients with ACI treated with intravenous thrombolysis at admission is consistent with a previous study’s results on 3-month mortality [ 11 ]. The proportions of our patients with cTnI elevation and ACI treated with rt-PA therapy (33%) were similar to those reported previously (36%) [ 11 ].…”

“…The ascending risk of mortality in patients with ACI treated with intravenous thrombolysis at admission is consistent with a previous study’s results on 3-month mortality [ 11 ]. The proportions of our patients with cTnI elevation and ACI treated with rt-PA therapy (33%) were similar to those reported previously (36%) [ 11 ]. We extended the observation time to approximately 5.7 years, whereas other studies assessed short-term or in-hospital outcomes [ 1 , 9 ].…”

“…Elevated cTnI concentrations are observed in patients with ACI [ 1 ], indicating ascending risks of short-term mortality [ 1 , 9 ]. When referring to patients with ACI treated with thrombolytic therapy, there are relatively few studies concerning the association between cTnI concentration and long-term mortality [ 11 ].…”

Role of troponin as a biomarker for predicting outcome after ischemic stroke

“…In the present meta-analysis, two studies were from Norway,[ 8 12 ] one from China,[ 13 ] two from Denmark,[ 14 15 ] two from Germany,[ 16 17 ] one from Israel,[ 18 ] one from Italy,[ 7 ] one from Korea,[ 19 ] one from New Zealand,[ 9 ] two from Poland,[ 20 21 ] one from Slovenia,[ 22 ] one from Spain,[ 23 ] one from Taiwan,[ 24 ] one from the UK,[ 25 ] and two from the USA. [ 26 27 ] Among all twelve were prospective cohort study[ 7 9 12 13 14 15 16 20 21 22 25 27 ] and seven were retrospective cohort study. [ 8 17 18 19 23 24 26 ] Studies included a minimum of 40[ 12 ] to a maximum of 1,718[ 27 ] patients.…”

Тропонины. Клиническое Значение И Интерпретация Результатов Лабораторных Тестов

“…Кроме диагностического значения, повышение уровня тропонинов имеет также прогностическое значение. Доказано прогностическое значение повышения hs-cTn в отношении неблагоприятных исходов у больных не только с ИМ [18], но и с хроническими коронарными синдромами, ХСН, тромбоэмболией легочной артерии, ишемическим инсультом [19], а также с легочной гипертензией.…”