Key result
Elevated hs-TnI at ischemic stroke admission is linked to ~212% higher MACCE risk.
Why the study?
Early recognition and risk stratification of cardiovascular events are necessary after ischemic stroke, prompting exploration of the prognostic role of hs-TnI on mortality and cardiovascular outcomes.
Does elevated hs-TnI predict MACCE and mortality in patients with acute ischemic stroke?
Cohort (n=1,019)
No
Does elevated hs-TnI predict MACCE and mortality in patients with acute ischemic stroke?
Elevated hs-TnI at admission for acute ischemic stroke is a strong independent predictor of subsequent major adverse cardiac and cerebrovascular events and mortality.
Answers are grounded in this paper and cite their sources.
May inform closer cardiac monitoring after ischemic stroke; leaves open whether targeted interventions improve outcomes.
INTRODUCTION: Early recognition and risk stratification of cardiovascular events are necessary in patients after ischemic stroke. Recent evidence suggests that elevated high-sensitive cardiac troponin is a predictor of mortality and vascular events. Therefore, we aimed to explore the prognostic role of high-sensitive cardiac troponin I (hs-TnI) on mortality and cardiovascular outcomes in patients after ischemic stroke. METHODS: From August 2014 to July 2017, 1,506 patients with acute ischemic stroke were pulled consecutively in a retrospective single-center registry. Of these, 1,019 patients were selected and classified into the elevated or non-elevated hs-TnI groups according to hs-TnI level of 99th percentile upper reference limit (URL) at the time of admission for ischemic stroke. The primary outcome was a major adverse cardiac and cerebrovascular event (MACCE) during follow-up. RESULTS: Among 1,019 patients, 708 patients were non-elevated hs-TnI group (<99th percentile URL of hs-TnI) and 311 patients were elevated hs-TnI group (≥99th percentile URL of hs-TnI). The median follow-up period was 22.5 (interquartile range 5.0-38.8) months. In a multivariable Cox regression model, the elevated hs-TnI group has a higher risk of MACCE (adjusted hazard ratio [HR]: 3.12; 95% confidence interval [CI]: 2.33-4.17; p < 0.01), all-cause mortality (adjusted HR: 4.15; 95% CI: 2.47-6.99; p < 0.01) and readmission caused by coronary revascularization (adjusted HR: 3.12; 95% CI: 1.41-6.90; p < 0.01), heart failure (adjusted HR: 2.76; 95% CI: 1.38-5.51; p < 0.01), and stroke (adjusted HR: 1.73; 95% CI: 1.07-2.78; p = 0.02) compared with the non-elevated hs-TnI group. CONCLUSIONS: Elevated hs-TnI is independently associated with higher mortality and cardiac and cerebrovascular events in patients with ischemic stroke and may serve as a valuable prognostic factor in management after ischemic stroke.
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Kim et al. (2022) conducted a cohort in Acute ischemic stroke (n=1,019). Elevated hs-TnI (≥99th percentile URL) vs. Non-elevated hs-TnI (<99th percentile URL) was evaluated on Major adverse cardiac and cerebrovascular event (MACCE) (adjusted HR 3.12, 95% CI 2.33-4.17, p=< 0.01). Elevated hs-TnI at admission for ischemic stroke was associated with a higher risk of MACCE compared to non-elevated levels.
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