Early Elevated Troponin Levels After Ischemic Stroke Suggests a Cardioembolic Source
| Autor: | Morgan Hemendinger, Alexander E Merkler, Brittany A Ricci, Priya Narwal, Katarina Dakay, Tracy E. Madsen, Michael E. Reznik, Karen L. Furie, Shawna Cutting, Mitchell S.V. Elkind, Tina Burton, Ryan A McTaggart, Brian Mac Grory, Matthew S Siket, Michael P Lerario, Emile Mehanna, Andrew D Chang, Hooman Kamel, Shadi Yaghi, Christopher Song, Mahesh V Jayaraman |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Heart Diseases Embolism Disease 030204 cardiovascular system & hematology Brain Ischemia 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans In patient Prospective Studies Registries Aged Advanced and Specialized Nursing biology business.industry Odds ratio medicine.disease Troponin Confidence interval Stroke Unknown Source Heart failure Ischemic stroke Cardiology biology.protein Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Stroke. 49:121-126 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.117.019395 |
| Popis: | Background and Purpose— Elevated cardiac troponin is a marker of cardiac disease and has been recently shown to be associated with embolic stroke risk. We hypothesize that early elevated troponin levels in the acute stroke setting are more prevalent in patients with embolic stroke subtypes (cardioembolic and embolic stroke of unknown source) as opposed to noncardioembolic subtypes (large-vessel disease, small-vessel disease, and other). Methods— We abstracted data from our prospective ischemic stroke database and included all patients with ischemic stroke during an 18-month period. Per our laboratory, we defined positive troponin as ≥0.1 ng/mL and intermediate as ≥0.06 ng/mL and Results— We identified 1234 patients, of whom 1129 had admission troponin levels available; 10.0% (113/1129) of these had a positive troponin. In fully adjusted models, there was an association between troponin positivity and embolic stroke of unknown source subtype (adjusted odds ratio, 4.46; 95% confidence interval, 1.03–7.97; P =0.003) and cardioembolic stroke subtype (odds ratio, 5.00; 95% confidence interval, 1.83–13.63; P =0.002). Conclusions— We found that early positive troponin after ischemic stroke may be independently associated with a cardiac embolic source. Future studies are needed to confirm our findings using high-sensitivity troponin assays and to test optimal secondary prevention strategies in patients with embolic stroke of unknown source and positive troponin. |
| Databáze: | OpenAIRE |
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