Highly Sensitive Cardiac Troponin T Changes and Its Prognostic Value in Patients with Acute Stroke

Background: The Acute ischemic stroke (AIS), which results in the corresponding loss of the neurological function, is characterized by sudden losses in the brain of blood circulation. Cardiac troponins (cTns) are used routinely for diagnosing acute myocardial infarction (AMI), but there is a complex overlap between cardiovascular and cerebrovascular disease. The aim of this study was to evaluate the incidence of Hs-cTnT elevation in acute ischemic stroke population and its prognostic significance. Patients and methods: We enrolled 161 patients admitted with acute ischemic stroke to Menoufia university hospitals and Assalam International hospital. We assessed the full medical history, neurological assessment, National Institutes of Health Stroke Scale (NIHSS), high-sensitive cardiac troponin T (hs-cTnT) level, and ECG on admission and after 24 hours. Statistical analysis was done using R-package for statistical analysis using the appropriate tests. Results: Our results revealed troponin in admission was elevated above >14 ng/dL in 58% of patients. Troponin dynamicity (delta troponin) defined as 25% increase in the admission value was found in 56% of patients. Analyzing ECG changes and echocardiographic findings revealed significant difference between delta troponin group and static troponin group regarding QTc prolongation (p=0.003), T wave changes (p=0.001), ST segment changes (p=0.013), and reduced ejection fraction (p=0.001). Poor outcome defined in our study as modified ranking scale ≥ 3 was found in 48.4% of patients, and good outcome found in 51.6% of patients. Conclusion: The acute Hs-cTnT elevation is high in acute ischemic stroke population, Hs-cTnT dynamicity within 24 hours is common, and delta troponin is correlated with stroke severity and poor outcome.