Elevated admission high-sensitivity troponin T in patients with transient ischemic attack was independently associated with recurrent acute ischemic stroke (aHR 1.73; 95% CI 1.01-2.98).
Cohort (n=1,478)
No
Does elevated hs-cTnT on admission predict recurrent AIS, MACE, and mortality in patients with TIA?
Elevated hs-cTnT after TIA is independently associated with recurrent acute ischemic stroke, MACE, and long-term mortality, suggesting its value for risk stratification and secondary prevention.
Effect estimate: aHR 1.73 (95% CI 1.01-2.98)
Abstract Background and aims High-sensitivity troponin T (hs-cTnT) is frequently elevated after transient ischemic attacks (TIAs). Yet, unlike in acute ischemic stroke (AIS), its prognostic value remains underexplored. This study aimed to evaluate associations between admission hs-cTnT levels in patients with TIA and clinical outcome events. Methods Consecutive TIA patients treated at our tertiary stroke center (2015-2019) were included. Hs-cTnT levels were measured on admission as part of routine clinical care. Patients were grouped based on whether hs-cTnT levels were within the normal range or elevated. The primary outcome was recurrent AIS. Secondary outcomes included major adverse cardiovascular events (MACE; composite of cardiovascular death, myocardial infarction, and AIS) and all-cause mortality during long-term follow-up. Associations between hs-cTnT and outcomes were assessed using Cox proportional hazards models with multivariable adjustment. Predefined subgroup analyses were performed restricted to patients with hs-cTnT levels ≥5-fold above the upper reference limit. Results n = 1478 patients were included (47% female, median age 72 years, 6% with recurrent AIS). In multivariable analysis, elevated hs-cTnT was independently associated with recurrent AIS (adjusted HR aHR 1.73, 95% CI 1.01–2.98), MACE (aHR 1.52, 95% CI 1.07–2.16), and all-cause mortality (aHR 4.68, 95% CI 3.30–6.63). In patients with ≥5-fold elevated hs-cTnT, there was an independent association with MACE and all-cause mortality, but not in recurrent AIS. Conclusions Elevated hs-cTnT after TIA seems to be associated with recurrent AIS, MACE, and long-term mortality. These findings underscore the potential role of hs-cTnT for risk stratification and support intensified diagnostic and secondary prevention strategies. Conflict of interest Regarding the scope of this abstract, the authors have nothing to disclose.
Bücke et al. (Fri,) conducted a cohort in Transient Ischemic Attacks (n=1,478). Elevated high-sensitivity troponin T (hs-cTnT) vs. Normal range hs-cTnT was evaluated on Recurrent acute ischemic stroke (AIS) (aHR 1.73, 95% CI 1.01-2.98). Elevated admission high-sensitivity troponin T in patients with transient ischemic attack was independently associated with recurrent acute ischemic stroke (aHR 1.73; 95% CI 1.01-2.98).