Elevated hs-TnI at admission for ischemic stroke was associated with a higher risk of MACCE compared to non-elevated levels (adjusted HR 3.12; 95% CI 2.33-4.17; p<0.01).
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.
Effect estimate: adjusted HR 3.12 (95% CI 2.33-4.17)
p-value: p=< 0.01
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.
Kim et al. (Fri,) 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 (adjusted HR 3.12; 95% CI 2.33-4.17; p<0.01).