Prognostic value of cardiac troponin I in acute ischemic stroke patients treated with reperfusion therapy: a multicenter retrospective cohort study

BACKGROUND: We aimed to evaluate the association between elevated cardiac troponin I (cTnI) and clinical outcomes in AIS patients receiving reperfusion therapy. METHODS: We conducted a multicenter retrospective cohort study of AIS patients treated with thrombolytics at Southern Illinois Healthcare and the University of Oklahoma (2017-2024). Demographic, clinical, laboratory, and radiographic data were collected. Elevation of cTnI was defined as levels above 0.028 ng/mL. For high sensitivity troponins, the cutoff was 15 ng/L for women and 20 ng/L for men. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and functional status at 30 days (good outcome defined as mRS ≤2). Overlap-weighted multivariable logistic regression was performed, adjusting for demographics, comorbidities, and stroke severity. RESULTS: > 0.05). CONCLUSIONS: In our study, elevated cTnI on admission is an independent predictor of poor short-term outcomes in AIS patients treated with reperfusion therapy. Troponin measurement may provide important prognostic information, particularly in older patients and those with more severe strokes.