Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies, Amiens University Hospital, Amiens, France.
Eur Neurol. 2010;63(1):24-8. doi: 10.1159/000258679. Epub 2009 Nov 17.
Elevated levels of cardiac troponin I (cTnI) have been reported in acute stroke and atrial fibrillation (AF). We tested a hypothesis in which the result of an initial cTnI assay helps predict new-onset AF (NAF) early in the course of ischaemic stroke in patients with sinus rhythm on admission.
This retrospective study included all patients admitted to our unit for acute ischaemic stroke between January 2006 and December 2007 (n = 402). NAF was defined as AF discovered during cardiac monitoring in patients with sinus rhythm on admission. Elevated cTnI was defined as a value > or =0.03 microg/l.
27 (6.7%) patients had NAF. In a univariate analysis, age (70.8 in patients with NAF vs. 64.6 years in patients without NAF, respectively; p = 0.024), smoking status (3.5 vs. 25.3%; p = 0.009), total anterior circulation infarcts (18.5 vs. 5.9%; p = 0.03) and elevated cTnI levels (63.0 vs. 29.9%; p = 0.001) were associated with NAF. Stepwise logistic regression identified elevated cTnI levels (OR 4.1; 95% CI 1.81-9.33; p = 0.001)and active smoking (OR 0.11; 95% CI 0.01-0.82; p = 0.03) as independent factors for NAF.
Moderately elevated troponin levels in acute ischaemic stroke are independently associated with NAF.
已有研究报道，在急性脑卒中及心房颤动（AF）患者中，心肌肌钙蛋白 I（cTnI）水平升高。本研究旨在验证一个假说，即入院时窦性节律患者初始 cTnI 检测结果有助于预测其在缺血性脑卒中发病早期是否会发生新发心房颤动（NAF）。
本回顾性研究纳入 2006 年 1 月至 2007 年 12 月期间在我院因急性缺血性脑卒中住院的所有患者（n = 402）。入院时窦性节律患者中发现的 AF 定义为 NAF。cTnI 升高定义为值> =0.03μg/l。
27 例（6.7%）患者发生 NAF。单因素分析显示，NAF 组患者年龄（70.8 岁 vs. 64.6 岁，p = 0.024）、吸烟状态（3.5% vs. 25.3%，p = 0.009）、完全前循环梗死（18.5% vs. 5.9%，p = 0.03）和 cTnI 水平升高（63.0% vs. 29.9%，p = 0.001）的比例高于无 NAF 组。多因素 logistic 回归分析显示，cTnI 水平升高（OR 4.1；95% CI 1.81-9.33；p = 0.001）和吸烟（OR 0.11；95% CI 0.01-0.82；p = 0.03）是 NAF 的独立危险因素。
急性缺血性脑卒中患者 cTnI 水平中度升高与 NAF 独立相关。
