Relationship between serum high-sensitive cardiac troponin i level and prognosis at 90 d in patients with acute ischemic stroke / 中国脑血管病杂志

ABSTRACT

Objective To study the relationship between serum high-sensitive cardiac troponin I (hs-Tnl) level and prognosis at 9 d in patients with acute ischemic stroke. Methods A total of 1 717 consecutive patients with acute ischemic stroke treated at the Department of Neurology, the First Affiliated Hospital of Harbin Medical University from September to November 2017 were enrolled retrospectively. The clinical data of all patients were collected,including vital signs at admission,laboratory indicators,and past medical history. The levels of hs-Tnl were determined by chemiluminescent particle immunoassay. The severity of stroke at admission was assessed by the National Institutes of Health Stroke Scale (NIHSS) ,and the prognosis at 90 d was evaluated by the modified Rankin scale (MRS). They were divided into good prognosis (MRS 0 -2) group and poor prognosis (MRS 3 -6) group according to the MRS score at 90 d follow-up. Multivariate logistic regression was used to analyze the relationship between hs-Tnl and prognosis at 90 d. Results Follow-up 90 days after discharge, of the 1 717 patients,! 322 had good prognosis, 395 had poor prognosis, the MRS score was 0 - 6[2(1,3)]. Compared with the good prognosis group, female (44.6% [n=176] vs. 32. 3% [n=427],∗2 =20. 05),age (67 [58,75] years vs. 62 [54,69] years,∗2 = 50. 22) , NIHSS score at admission (7 [5,10] vs. 3 [2,4],∗2 =348. 35],and hs-Tnl levels (0.01 [0,0.01] p.g/L vs.0 [0,0.01] ixg/L,∗2 = 29. 44),white blood cell count (8.43 [6.79,10.42] x 10VLt.7.51 [6.21,9. 13] x lO'/L,∗2 = 32.42),systolic blood pressure (150 [140,170] mmHg vs. 150 [135,165] mmHg,∗2 =4. 22) .hospital stay (8 [6,9] d vs. 1 [6,8] d,∗2 =49. 06) , the proportion of patients with previous stroke history (54. 2% [n =214] ts. 42. 3% [n =559] j(2 = 17. 38] ,and increased hs-Tnl (16. 7% [n = 66] vs. 8. 9% [n = 118] ,∗2 = 19. 25) and the proportion of patients in clinical deterioration (18. 5% [n = 73] vs. 2. 7% [n = 36] ,∗2 = 127. 02) were all higher than the those of the good prognosis group. The proportions of patients with smoking history (34. 7% [n = 137] w.44.0% [n = 582] ,x2 = 10. 90] .creatinine (67. 4 [56. 4,84. 7]u.mol/L vs. 70. 9 [60.8, 81. 2]u,mol/L,∗2 = 4. 26),hemoglobin (140 [126,149]g/L vs. 142 [131 ,153] g/L,∗2 = 14. 95) , and hematocrit (42. 2 [38. 6 , 44. 7%] vs. 42. 8 [39. 8 , 45. 6%] ,∗2 = 13. 16) were lower than those of the good prognosis group. The differences were statistically significant (P 60 years (Oft, 1.59,95% CI 1.18-2. 14), history of previous stroke (Oft,1.46,95% CI 1. 11 -1. 92) , NIHSS score 3s 5 at admission (Oft, 11. 49,95% CI 8. 57-15. 4) ,elevated hs-Tnl (Oft,1.56,95% CI 1. 05 -2. 32) ,and clinical deterioration (Oft,14. 71,95% CI 8. 89-24. 33) were the independent risk factors for poor prognosis at 90 d,and elevated hemoglobin (Oft, 0. 62 , 95% CI 0. 43 -0. 88) was a protective factor of good prognosis at 90 d (all P < 0. 05). Conclusion Elevated serum hs-Tnl in patients with acute ischemic stroke was an independent risk factor of poor prognosis at 90 d.