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

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.