The Relationship Between Mean Platelet Volume (MPV) and Cardiac Troponin I (cTnI) Levels and Mortality in Patients with Ischemic Stroke

Introduction: Acute ischemic stroke is one of the important causes of mortality and morbidity. It is responsible for approximately 5% of in-hospital mortality. Early recognition of risk factors for mortality in acute ischemic stroke cases is important in terms of disease management and appropriate family information. In this study, we aimed to investigate the relationship between Cardiac Troponin I (cTnI) and Mean Platelet Volume (MPV) and mortality in patients with acute ischemic stroke. Methods: Patients who applied to the Emergency Medicine Clinic between 01.01.2016 and 01.01.2018, whose diagnosis code was entered as cerebrovascular disease (CVD) and whose magnetic resonance diffusion imaging tests were reported as acute infarct by the radiology clinic were screened, and the patients' age, gender, current comorbid diseases, mean platelet volume (MPV) and troponin values were recorded. Mortality status of the patients were screened through the Turkish Republic Ministry of Health Death Notification System, and their first and third month mortality were recorded. Patients with elevated troponin and suspected acute coronary syndrome by a cardiology or emergency medicine specialist were excluded. Results: A total of 357 patients were included in our study. The median age of the patients was 72 (IQR: 62-81). While 43 (12%) of 357 patients died within the first month, 66 (18.5%) of them died within the first three months. When the relationship between the first month and third month mortality of the patients and their comorbid diseases was examined, it was found that only the presence of dementia had a significant relationship with the third month mortality (Chi-square, p=0.021). When the relationship between MPV and troponin values of the patients and their first and third month mortality was examined, a significant relationship was found between first month mortality and troponin (Mann-Whitney U, p<0.001) and third month mortality and troponin (Mann-Whitney U, p<0.001). Discussion and Conclusion: It was concluded that troponin elevation in patients with acute ischemic stroke is a parameter that may be useful in estimating the risk of mortality.