Clinical significance of elevated serum cardiac troponin T and associated risk factors in patients diagnosed with acute ischemic stroke

Abstract

Objective: We explored the clinical significance and associated risk factors of increased levels of serum cardiac troponin T (cTnT) in individuals suffering from acute ischemic stroke (AIS).

Methods: Our study subjects consisted of patients who were admitted with AIS within 48 hours of its onset. These study participants were categorized based on their levels of cTnT into two groups: normal cTnT group and elevated cTnT group. We collected and subjected a range of data to statistical analysis, including general clinical traits, medical history, laboratory test results, electrocardiograms, imaging scans, and medical records like the National Institute of Health Stroke Scale (NIHSS) scores of the patients.

Results: Out of the 232 patients diagnosed with AIS, 84 individuals (36.21%) exhibited raised levels of cTnT. When comparing this elevated cTnT cohort to the group with regular cTnT levels, those with elevated cTnT were older [with a median age of 76 year (interquartile range: 67 to 83) as compared to 70 year interquartile range: 61 to 79), P = 0.002], and they presented with higher NIHSS scores upon admission [8.5 (interquartile range: 4 to 14) compared to 5 (interquartile range: 2 to 9), p = 0.002]. In addition, a larger percentage of patients in the elevated cTnT group had both coronary artery disease (23.81% vs. 7.43%, P < 0.001) and cardiac insufficiency (25.00% vs. 3.38%, P < 0.001) as comorbidities. Meanwhile, the elevated cTnT group also displayed a higher occurrence of electrocardiogram abnormalities, including bundle branch block (29.76% vs. 9.46%, P < 0.001) and atrial fibrillation (32.14% vs. 11.49%, P < 0.001), in comparison to the normal cTnT group. The clinical data and related laboratory indicators of patients were collected for risk factor analysis, which showed that bundle branch block [odds ratio (OR) = 4.17, 95% confidence interval (95%CI) = 1.43–12.16), log to base 10 N-terminal pro-brain natriuretic peptide (Log10NT-proBNP; OR = 3.41, 95%CI = 1.62-7.16), cystatin C (OR = 6.86, 95%CI = 2.01–23.43), and neutrophil/lymphocyte ratio (OR = 1.13, 95%CI = 1.02–1.25) were independent risk factors for elevated cTnT in patients with AIS.

Conclusions: Older patients with AIS who had higher levels of cTnT exhibited more severe neurological impairments and a greater number of comorbidities. Furthermore, an elevated cTnT in patients with AIS may be linked to cardiac insufficiency, changes in kidney function, and signs of inflammation.