Abstract TP244: Correlation of Elevated Serum Troponin with Core Volume in Ischemic Stroke

Intro: Serum troponin is a biomarker commonly used in the evaluation of coronary artery disease. Elevated levels have also been observed in patients with acute ischemic stroke (AIS). Co-morbid factors, such as coronary artery disease, heart failure, and atrial fibrillation have been identified as contributors to troponin elevation during AIS. However, the relationship between elevated serum troponin and ischemic core volume has not been clearly defined. The goal of this study was to investigate the association between ischemic core size and serum troponin elevation. Methods: This was a multi-site, retrospective study of consecutive ischemic stroke patients over a 2-year period who received magnetic resonance (MR) imaging with diffusion and perfusion imaging (DWI) on arrival. Demographics, clinical variables, and imaging data were abstracted from the institutional stroke quality database and electronic health records. Patients who had troponin level on arrival were included for analysis. A troponin of >0.04 ng/mL was considered elevated. Ischemic stroke volume was defined by the core and hypoperfusion volumes taken from the output of RAPIDai processing of imaging. Results: A total of 96 patients with an ischemic stroke and MR perfusion imaging were included in the analysis. Key descriptive statistics for the entire sample are given in the two tables. Core volumes were not significantly different in patients with elevated troponin. Mean (SD) volume was 36.0 (60.5) mL for the normal troponin group (n=73) and 52.1 (64.9) mL for the elevated troponin group (n=23). These were not significantly different. There was a significant but weak correlation between core volume and troponin values (Pearson correlation r=0.21, p=0.04). Multivariate logistic regression adjusting for other factors failed to find a significant relationship of core volume to elevated troponin, but there was a positive association with NIHSS on admission, and a marginal association with sex. Thirty percent of females had elevated troponin versus 17% of males (Table 2). Conclusion: Elevated troponin was not clearly associated with core volume of ischemic lesion on admission DWI in this small sample. Extended analysis using a larger sample is planned to investigate whether the marginal and nominal associations between core volumes and elevated troponin suggested by these data and interactions with cardiac history and sex and stroke severity can be confirmed.