Abstract | PURPOSE: The importance of troponin elevation at stroke presentation remains uncertain. We aimed to assess whether baseline ultrasensitive Troponin I (hs-TnI) predicts cardiac complications and outcome in acute stroke patients. METHOD:
Stroke patients admitted within 6 h were consecutively enrolled from May 2013 to March 2014. Blood samples were taken at admission to determine hs-TnI by chemiluminescent microparticle immunoassay. hs-TnI > 34.2 pg/ml (male) and >15.6 pg/ml (female) were considered elevated. Complications during in- hospital stay and outcome at 90 days were prospectively recorded. Independent predictors of cardiac complications ( heart failure and acute coronary syndrome) and mortality were determined by logistic regression. The additional predictive value of hs-TnI was evaluated by integrated discrimination improvement index. A subanalysis was performed after excluding patients with previous cardiac diseases. FINDINGS: From 174 patients, 39(22%) had elevated hs-TnI, having these patients higher incidence of cardiac complications (57% versus 19%, p = 0.004). hs-TnI was an independent predictor of cardiac complications (OR = 16.1 (1.7-150.3)) together with diastolic blood pressure (OR = 0.92 (0.86-0.99)). Addition of hs-TnI to clinical variables significantly improved discrimination (IDI = 15.2% (7.8-22.7)). Subanalysis in patients without previous cardiac diseases showed similar results. Elevated hs-TnI was independently associated with 90 days mortality (OR = 3.6 (1.3-9.4)), but addition of hs-TnI to clinical data did not result in an increased discrimination. DISCUSSION: The present study confers hs-TnI a 2b level of evidence as a diagnostic tool to predict cardiac complications in stroke. Absence of serial hs-TnI measurements and limited sample size are the main weaknesses of the study. CONCLUSION: Patients with elevated baseline hs-TnI showed a higher frequency of cardiac complications and a higher mortality. Measurement of hs-TnI in acute stroke might be useful to identify patients at a high risk of cardiac complications and death.
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Authors | Alejandro Bustamante, Belén Díaz-Fernández, Jorge Pagola, Albert Blanco-Grau, Marta Rubiera, Anna Penalba, Teresa García-Berrocoso, Joan Montaner |
Journal | European stroke journal
(Eur Stroke J)
Vol. 1
Issue 3
Pg. 205-212
(Sep 2016)
ISSN: 2396-9881 [Electronic] England |
PMID | 31008281
(Publication Type: Journal Article)
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