Британский журнал исследований Открытый доступ

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Elevation of Troponin I in Ischemic Stroke of Outcomes in Patients with Acute Stroke

AK AL Miraj*, Quazi Deen Mohammad, Shahidur Rahman, Moyeenuzzaman, Shamim Miah

Background: Stroke is the second leading cause of death in the world, comprising approximately 10% of all deaths. Troponin is a sensitive marker of myocardial injury. Rise in serum troponin is characteristic for myocardial ischemic injury; however it can rise in several other conditions (e.g. renal failure, heart failure, pulmonary edema, and sepsis). Stroke is the second leading cause of death worldwide, comprising approximately 10% of all deaths. A substantial number of stroke patients have elevated cardiac troponin levels and are associated with poorer prognosis.

Methods: This prospective observational study was done at the department of neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January to 100 acute ischemic stroke patients was enrolled. Data included vital signs, laboratory parameters, and clinical features evaluated at the time of admission. The National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess stroke severity and outcomes.

Results: A total of 100 patients with acute ischemic stroke were enrolled in the study, and clinical and demographic characteristics the mean age was 58.68 ± 17.36. The mean age of patients in both groups. Elevated troponin I (>0.034 mg/ml) was observed in eight (8.00%) patients. Compared to patients with normal troponin I, patients with elevated troponin I were older (mean age 61 vs. 59.68 years), had higher blood glucose( 10.6 vs. 7.04 mmol/L), higher median white blood cells (9.3 vs. 8.9 1,000/m³) and creatinine levels(118.5 μmol/L vs. 94.9 μmol/L), higher mean NIHSS scores on admission (15 vs. 8.6), and discharge (13.5 vs. 6.8), higher median mRS scores (4.13 vs. 1.8) at discharge (p¹³ (OR 15.902; 95% CI (3.6569.28), p=0.029 mg/mL (odds ratio (OR):28.451; 95% CI (2.785-290.6), p=0.005) were significant predictors of poor outcomes. Significant predictor of in hospital mortality only included troponin I level>0.04 ng/mL (OR 0.071; 95% CI (0.005-1.037), P=0.05).

Conclusion: Elevation of troponin I in ischemic stroke independently predicted unfavorable functional outcomes at discharge and in hospital mortality. Compared to other laboratory parameters, troponin I is a better predictor of outcomes of stroke. Careful and prompt evaluation of patients with acute stroke is needed in the setting of elevated troponin I.