What is the clinical evidence from this study?

Study design: Cohort. Population: Acute ischemic stroke (n=1049). Intervention: Dynamic elevation of high-sensitivity cardiac troponin T (hs-cTnT) vs. Non-dynamic elevation of hs-cTnT. Primary outcome: 3-month functional independence (mRS score 0-2) (OR 0.67, 95% CI 0.47-0.97, p=0.036).

January 12, 2026Open Access

Association between dynamic elevation of high-sensitivity cardiac troponin T and functional outcomes in patients with acute ischemic stroke

Key Result

Dynamic elevation of high-sensitivity cardiac troponin T in patients with acute ischemic stroke was independently associated with a reduced likelihood of 3-month functional independence (OR 0.67).

Study Design

Type

Cohort (n=1,049)

Multicenter

Yes

Structured PICO

Does dynamic elevation of hs-cTnT predict early neurological deterioration and poorer 3-month functional outcomes in patients with acute ischemic stroke?

Population

1049 patients with acute ischemic stroke (AIS) who underwent two hs-cTnT measurements during hospitalization, median age 73 years, 38.7% female.

Intervention

Dynamic elevation of high-sensitivity cardiac troponin T (hs-cTnT) (increase by >20% from baseline level)

Comparator

Non-elevation of hs-cTnT

Outcome

Early neurological deterioration (END) [defined as a ≥4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days of onset] and 3-month functional independence [defined as a modified Rankin Scale (mRS) score of 0-2]hard clinical

In patients with acute ischemic stroke, in-hospital dynamic elevation of hs-cTnT is an independent predictor of early neurological deterioration and worse 3-month functional outcomes.

Main Result

Effect estimate: OR 0.67 (95% CI 0.47-0.97)

Absolute Event Rate: 36.71% vs 48.71%

p-value: p=0.036

Limitations

Retrospective cohort design may introduce selection bias.
Observational nature precludes establishing causality.
Long interval between hs-cTnT measurements (median 2 days) may miss transient elevations.
Lack of fixed time points and multiple measurements to assess specific hs-cTnT change trajectories.
Potential residual confounding from unmeasured factors like eGFR, BMI, infection, and stress hyperglycemia.

Abstract

ObjectiveTo investigate the association between in-hospital dynamic elevation of high-sensitivity cardiac troponin T (hs-cTnT) and both early neurological deterioration (END) and 3-month functional outcomes in patients with acute ischemic stroke (AIS).MethodsData of AIS patients who underwent two hs-cTnT measurements during hospitalization between March 2017 and November 2024 were extracted from the CIPPIS database for retrospective analysis. Based on whether hs-cTnT increased by more than 20% from the baseline level, patients were categorized into a dynamic elevation group and a non-elevation group. The incidences of END defined as a ≥4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days of onset and 3-month functional independence defined as a modified Rankin Scale (mRS) score of 0-2 were compared between the two groups. Binary logistic regression was used to analyze the relationship between hs-cTnT dynamic elevation and the outcomes. Sensitivity analysis (after excluding patients with acute myocardial infarction or severe renal dysfunction) and subgroup analyses were performed to assess the robustness of the findings.ResultsA total of 1049 patients were included (median age 73 years). Among them, 406 patients (38.7%) were female, 226 patients (21.5%) exhibited hs-cTnT dynamic elevation. Compared with the non-elevation group, the dynamic elevation group had a significantly higher incidence of END (9.71% vs. 15.42%, Pvs. 26.57%, Pvs. 36.71%, Pvs. 55.56%, Pvs. 14.01%, PPCI: 0.44-0.96, PCI: 0.48-0.94, PP>0.05).ConclusionIn patients with AIS, in-hospital dynamic elevation of hs-cTnT is independently associated with an increased risk of early neurological deterioration and poorer 3-month functional outcomes. This association may reflect the adverse impact of acute myocardial injury on stroke prognosis.

Bookmark

View Full Paper