The International journal of neuroscience · 2025
Prognostic value of cardiac troponin I in acute ischemic stroke patients treated with reperfusion therapy: a multicenter retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Loggini Andrea, Bonin Pinto Camila, Von Hagn Heather, Boada Robayo Laura, Schwertman Amber, Pixley Kaitlyn, Nagai Michiaki, Sajid Ayesha, Lawson Trace, Saleh Velez Faddi G
Аннотация
BACKGROUND: We aimed to evaluate the association between elevated cardiac troponin I (cTnI) and clinical outcomes in AIS patients receiving reperfusion therapy.
METHODS: We conducted a multicenter retrospective cohort study of AIS patients treated with thrombolytics at Southern Illinois Healthcare and the University of Oklahoma (2017-2024). Demographic, clinical, laboratory, and radiographic data were collected. Elevation of cTnI was defined as levels above 0.028 ng/mL. For high sensitivity troponins, the cutoff was 15 ng/L for women and 20 ng/L for men. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and functional status at 30 days (good outcome defined as mRS ≤2). Overlap-weighted multivariable logistic regression was performed, adjusting for demographics, comorbidities, and stroke severity.
RESULTS: Among 496 patients, 143 (29%) had elevated cTnI. Compared with patients with normal cTnI, those with elevated levels were older, had more vascular risk factors, and higher baseline NIHSS. Elevated cTnI was not significantly associated with sICH (OR:3.75, 95%CI 0.52-27.21, p = 0.19), but was independently associated with increased in-hospital mortality (OR:1.96, 95%CI 1.62-6.20, p = 0.025) and decreased odds of good functional outcome at 30 days (OR:0.40, 95%CI 0.19-0.84, p = 0.016). Subgroup analyses showed these associations were most pronounced in older patients and in those with moderate (NIHSS 6-15) to severe (NIHSS 16-20 and > 20) strokes, whereas no significant relationships were observed in younger patients or mild strokes. Normalization of cTnI during hospitalization did not improve survival (p > 0.05).
CONCLUSIONS: In our study, elevated cTnI on admission is an independent predictor of poor short-term outcomes in AIS patients treated with reperfusion therapy. Troponin measurement may provide important prognostic information, particularly in older patients and those with more severe strokes.
METHODS: We conducted a multicenter retrospective cohort study of AIS patients treated with thrombolytics at Southern Illinois Healthcare and the University of Oklahoma (2017-2024). Demographic, clinical, laboratory, and radiographic data were collected. Elevation of cTnI was defined as levels above 0.028 ng/mL. For high sensitivity troponins, the cutoff was 15 ng/L for women and 20 ng/L for men. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and functional status at 30 days (good outcome defined as mRS ≤2). Overlap-weighted multivariable logistic regression was performed, adjusting for demographics, comorbidities, and stroke severity.
RESULTS: Among 496 patients, 143 (29%) had elevated cTnI. Compared with patients with normal cTnI, those with elevated levels were older, had more vascular risk factors, and higher baseline NIHSS. Elevated cTnI was not significantly associated with sICH (OR:3.75, 95%CI 0.52-27.21, p = 0.19), but was independently associated with increased in-hospital mortality (OR:1.96, 95%CI 1.62-6.20, p = 0.025) and decreased odds of good functional outcome at 30 days (OR:0.40, 95%CI 0.19-0.84, p = 0.016). Subgroup analyses showed these associations were most pronounced in older patients and in those with moderate (NIHSS 6-15) to severe (NIHSS 16-20 and > 20) strokes, whereas no significant relationships were observed in younger patients or mild strokes. Normalization of cTnI during hospitalization did not improve survival (p > 0.05).
CONCLUSIONS: In our study, elevated cTnI on admission is an independent predictor of poor short-term outcomes in AIS patients treated with reperfusion therapy. Troponin measurement may provide important prognostic information, particularly in older patients and those with more severe strokes.