Prognostic Implications of Elevated Cardiac Troponin T in Patients with Acute Ischemic Stroke

ABSTRACT

BACKGROUND: Elevated cardiac troponin T (cTnT) levels have been reported in patients with acute ischemic stroke, however, the prognostic relevance is not well established. We evaluated the association between cTnT elevation and prognosis in patients with acute ischemic stroke. METHODS: The 182 consecutive patients enrolled had new-onset acute ischemic stroke. Their clinical and laboratory findings were collected retrospectively. Stroke severity and prognosis were determined using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) scores, as well as 30-day all-cause mortality. The patients were divided into two groups according to their cTnT levels ≤14 and >14 ng/L. Cox proportional hazards regression analysis was performed to determine the associations between clinical or laboratory variables and 30-day all-cause mortality. The Kaplan-Meier method was used to compare the overall survival rate in patients with elevated and normal cTnT levels. RESULTS: The cTnT level was elevated in 14.8% of the patients. Age, NIHSS and mRS scores, creatinine kinase-MB, and 30-day all-cause mortality were significantly higher in patients with elevated cTnT levels than in those with normal cTnT levels. The hazard ratio of the elevated vs. normal cTnT group for 30-day all-cause mortality was 8.06 (95% confidence interval 1.13-57.25, P=0.037). A Kaplan-Meier survival analysis revealed a significantly higher survival rate in patients with normal cTnT levels compared to those with elevated cTnT levels (P<0.0001). CONCLUSIONS: An elevated cTnT level is significantly associated with poor short-term outcomes in patients with acute ischemic stroke.