Open AccessElevation of high‐sensitivity cardiac troponin T at admission is associated with increased 3‐month mortality in acute ischemic stroke patients treated with thrombolysis
Author(s) -
Sui Yi,
Liu Ting,
Luo Jianfeng,
Xu Bing,
Zheng Liqiang,
Zhao Weijin,
Guan Qi,
Ren Li,
Dong Chunyao,
Xiao Ying,
Qin Xue,
Zhang Yao
Publication year - 2019
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23237
Subject(s) - medicine , thrombolysis , troponin complex , modified rankin scale , cardiology , logistic regression , odds ratio , troponin t , stroke (engine) , etiology , troponin , myocardial infarction , ischemic stroke , ischemia , mechanical engineering , engineering
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.