Elevated cardiac troponin levels significantly predicted higher in-hospital mortality in patients with acute ischemic stroke (RR 3.80) and subarachnoid hemorrhage (RR 2.23), but not intracerebral hemorrhage.
Meta-Analysis (n=21,435)
Do elevated cardiac troponin levels predict mortality in patients with acute stroke?
Elevated cardiac troponin levels serve as a significant predictive marker for both in-hospital and long-term mortality in patients with acute ischemic stroke and subarachnoid hemorrhage, but not intracerebral hemorrhage.
Relative Risk: 3.8 (95% CI 2.82–5.12)
Background and Aim: The prognostic potential of cardiac troponin (cTn) in acute stroke patients has been a subject of ongoing debate. Our objective was to provide a comprehensive evidence for predicting mortality in acute stroke patients by using the elevated troponin levels. Methods: We conducted an extensive literature search, including PubMed, EMbase, and Trip Databases, covering studies published up to September 30, 2023. We computed risk ratios (RR) with 95% confidence intervals (CIs), performed sensitivity analysis, and conducted trial sequential analysis (TSA). Results: In total, 53 studies were analyzed, with 37 focusing on acute ischemic stroke (AIS), 11 on subarachnoid hemorrhage (SAH), and 7 on Intracerebral hemorrhage (ICH). Elevated cTn levels were significantly showed a higher predictive risk for In-hospital mortality in both AIS (RR=3.80, 95% CI; 2.82 to 5.12) as well as SAH (RR=2.23, 95% CI; 1.64 to 3.02). However, no significant predictive risk between elevated cTn levels and in-hospital mortality for ICH patients (RR=1.13, 95% CI: 0.46 to 2.79). A similar pattern was observed for elevated cTn levels, indicating an increased risk of last follow-up mortality for AIS (RR=2.41, 95% CI: 1.98 to 2.93) and SAH (RR=3.08, 95% CI: 2.25 to 4.21). Conclusion: Elevated troponin levels can serve as a promising predictive marker for both in-hospital and last follow-up mortality in AIS and SAH patients but not in ICH patients. Further prospective studies are needed to validate our findings along with exploring the preventive management of mortality in acute stroke settings.
Gulia et al. (Mon,) conducted a meta-analysis in Acute stroke (n=21,435). Elevated cardiac troponin levels vs. Normal cardiac troponin levels was evaluated on In-hospital mortality in acute ischemic stroke (RR 3.80, 95% CI 2.82 to 5.12). Elevated cardiac troponin levels significantly predicted higher in-hospital mortality in patients with acute ischemic stroke (RR 3.80) and subarachnoid hemorrhage (RR 2.23), but not intracerebral hemorrhage.