J Stroke.
2017 Sep;19(3):312-322. 10.5853/jos.2016.01942.
Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke
- Affiliations
-
- 1Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. sunkwon7@gmail.com
- 2Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Korea.
- 3Clinical Research Center, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- 4Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
- 5Department of Neurology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
- KMID: 2408397
- DOI: http://doi.org/10.5853/jos.2016.01942
Abstract
- BACKGROUND AND PURPOSE
Troponin, a marker of myocardial injury, frequently increases and is related with poor outcome in ischemic stroke patients. However, the long-term outcome of this elevation remains uncertain. We, therefore, investigated the prognostic significance of troponin elevation for long-term mortality, and explored factors affecting troponin elevation after ischemic stroke.
METHODS
We retrospectively analyzed the medical data of stroke patients who were admitted within 24 hours of symptom onset and underwent a serum cardiac troponin I test at admission during a five-year period. Information on mortality as the outcome was obtained from the National Death Certificate system.
RESULTS
A total of 1,692 patients were eligible for inclusion with 33 months of median follow-up. Troponin elevation that exceeded the 99th percentile (>0.04 ng/mL) of values was detected in 166 patients (9.8%). After adjusting for baseline characteristics, troponin elevation was associated with previous ischemic heart disease and congestive heart failure, comorbid atrial fibrillation and active cancer, and increased National Institutes of Health Stroke Scale score. Patients with troponin elevation had a high risk of overall death (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.40-2.40), including stroke-related (HR 1.71, 95% CI 1.14-2.55), cardiac-related (HR 3.17, 95% CI 1.49-6.74), and cancer-related (HR 1.98, 95% CI 1.14-3.45) death than those without troponin elevation.
CONCLUSIONS
Troponin elevation in the acute stage of ischemic stroke was associated with long-term mortality, mainly due to increased stroke- and cancer-related death in the first year and cardiacrelated death in the later period.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Prognostic Implications of Elevated Cardiac Troponin T in Patients with Acute Ischemic Stroke
- Explanatory Power and Prognostic Implications of Factors Associated with Troponin Elevation in Acute Ischemic Stroke
- Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack
- Inhibition of LPA5 Activity Provides Long-Term Neuroprotection in Mice with Brain Ischemic Stroke
- Long-Term Mortality According to the Characteristics of Early Neurological Deterioration in Ischemic Stroke Patients
