Key result
Dynamic hs-cTnI changes, not baseline elevation, are linked to 90-day mortality after acute stroke MT.
Why the study?
The study was undertaken to evaluate the impact of high-sensitivity cardiac troponin I elevation and dynamic changes on 90-day mortality in patients with acute ischemic stroke treated with mechanical thrombectomy.
Do hs-cTnI elevation and dynamic changes predict 90-day mortality in patients with acute ischemic stroke after mechanical thrombectomy?
Cohort (n=423)
Do hs-cTnI elevation and dynamic changes predict 90-day mortality in patients with acute ischemic stroke after mechanical thrombectomy?
Dynamic changes in high-sensitivity cardiac troponin I, particularly a rising pattern, are independently associated with 90-day mortality in patients with acute ischemic stroke after mechanical thrombectomy.
Answers are grounded in this paper and cite their sources.
Dynamic hs-cTnI changes may flag higher 90-day mortality risk after MT; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: A study was undertaken to evaluate the impact of high-sensitivity cardiac troponin I (hs-cTnI) elevation and hs-cTnI dynamic changes on 90-day mortality in patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT). METHODS: Patients with AIS receiving MT were included in the study. Sixty hours after AIS onset, hs-cTnI levels were measured before and after MT to determine elevated and dynamic changes. Patients were stratified into either normal or hs-cTnI elevation groups according to the pre-MT hs-cTnI cut-off value of 0.03 ng/L. hs-cTnI dynamic changes were defined as an increase or decrease of more than 20% pre-MT and post-MT, and at least one hs-cTnI level >0.03 ng/L. Multivariate Cox regression models were used to investigate the association between hs-cTnI elevation, hs-cTnI dynamic changes, and 90-day mortality in patients with AIS after MT. RESULTS: A total of 423 patients with AIS after MT were included in our final analysis, of whom only 72 (17%) showed hs-cTnI elevation. Post-MT hs-cTnI retesting was performed in 354 patients, and 90 (25.4%) patients presented with hs-cTnI dynamic changes. 119 patients died within 90 days. After adjusting for potential confounding factors, the Cox regression model showed that patients with hs-cTnI dynamic changes, rather than hs-cTnI elevation, were associated with 90-day mortality (p<0.05). Compared with the hs-cTnI non-dynamic changes, these results showed that a statistical association was present between rising hs-cTnI dynamic changes and 90-day mortality (p>0.05). CONCLUSIONS: hs-cTnI dynamic changes, dominated by the rising pattern rather than hs-cTnI elevation, were independent factors associated with 90-day mortality in patients with AIS after MT, especially in elderly subjects.
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Chen et al. (2022) conducted a cohort in Acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT) (n=423). hs-cTnI dynamic changes vs. hs-cTnI non-dynamic changes was evaluated on 90-day mortality (p=<0.05). High-sensitivity cardiac troponin I dynamic changes, rather than baseline elevation, were significantly associated with 90-day mortality in patients with acute ischemic stroke after MT (p<0.05).
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