Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis
Background and AimThe prognostic potential of cardiac troponin (cTn) in acute stroke patients has been a subject of ongoing debate. Our objective was to provide a comprehensive evidence for predicting mortality in acute stroke patients by using the elevated troponin levels.MethodsWe conducted an ext...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1351925/full |
| _version_ | 1797246748706471936 |
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| author | Annu Gulia Manyata Srivastava Pradeep Kumar |
| author_facet | Annu Gulia Manyata Srivastava Pradeep Kumar |
| author_sort | Annu Gulia |
| collection | DOAJ |
| description | Background and AimThe prognostic potential of cardiac troponin (cTn) in acute stroke patients has been a subject of ongoing debate. Our objective was to provide a comprehensive evidence for predicting mortality in acute stroke patients by using the elevated troponin levels.MethodsWe conducted an extensive literature search, including PubMed, EMbase, and Trip Databases, covering studies published up to September 30, 2023. We computed risk ratios (RR) with 95% confidence intervals (CIs), performed sensitivity analysis, and conducted trial sequential analysis (TSA).ResultsIn total, 53 studies were analyzed, with 37 focusing on acute ischemic stroke (AIS), 11 on subarachnoid hemorrhage (SAH), and 7 on Intracerebral hemorrhage (ICH). Elevated cTn levels were significantly showed a higher predictive risk for In-hospital mortality in both AIS (RR=3.80, 95% CI; 2.82 to 5.12) as well as SAH (RR=2.23, 95% CI; 1.64 to 3.02). However, no significant predictive risk between elevated cTn levels and in-hospital mortality for ICH patients (RR=1.13, 95% CI: 0.46 to 2.79). A similar pattern was observed for elevated cTn levels, indicating an increased risk of last follow-up mortality for AIS (RR=2.41, 95% CI: 1.98 to 2.93) and SAH (RR=3.08, 95% CI: 2.25 to 4.21).ConclusionElevated troponin levels can serve as a promising predictive marker for both in-hospital and last follow-up mortality in AIS and SAH patients but not in ICH patients. Further prospective studies are needed to validate our findings along with exploring the preventive management of mortality in acute stroke settings. |
| first_indexed | 2024-04-24T19:47:44Z |
| format | Article |
| id | doaj.art-be314fb9ca234cdebfe54a6ddfc3fb25 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-24T19:47:44Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-be314fb9ca234cdebfe54a6ddfc3fb252024-03-25T04:31:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-03-011510.3389/fneur.2024.13519251351925Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysisAnnu GuliaManyata SrivastavaPradeep KumarBackground and AimThe prognostic potential of cardiac troponin (cTn) in acute stroke patients has been a subject of ongoing debate. Our objective was to provide a comprehensive evidence for predicting mortality in acute stroke patients by using the elevated troponin levels.MethodsWe conducted an extensive literature search, including PubMed, EMbase, and Trip Databases, covering studies published up to September 30, 2023. We computed risk ratios (RR) with 95% confidence intervals (CIs), performed sensitivity analysis, and conducted trial sequential analysis (TSA).ResultsIn total, 53 studies were analyzed, with 37 focusing on acute ischemic stroke (AIS), 11 on subarachnoid hemorrhage (SAH), and 7 on Intracerebral hemorrhage (ICH). Elevated cTn levels were significantly showed a higher predictive risk for In-hospital mortality in both AIS (RR=3.80, 95% CI; 2.82 to 5.12) as well as SAH (RR=2.23, 95% CI; 1.64 to 3.02). However, no significant predictive risk between elevated cTn levels and in-hospital mortality for ICH patients (RR=1.13, 95% CI: 0.46 to 2.79). A similar pattern was observed for elevated cTn levels, indicating an increased risk of last follow-up mortality for AIS (RR=2.41, 95% CI: 1.98 to 2.93) and SAH (RR=3.08, 95% CI: 2.25 to 4.21).ConclusionElevated troponin levels can serve as a promising predictive marker for both in-hospital and last follow-up mortality in AIS and SAH patients but not in ICH patients. Further prospective studies are needed to validate our findings along with exploring the preventive management of mortality in acute stroke settings.https://www.frontiersin.org/articles/10.3389/fneur.2024.1351925/fulltroponinmortalityacute strokeischemic strokeintracerebral hemorrhagesubarachnoid hemorrhage |
| spellingShingle | Annu Gulia Manyata Srivastava Pradeep Kumar Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis Frontiers in Neurology troponin mortality acute stroke ischemic stroke intracerebral hemorrhage subarachnoid hemorrhage |
| title | Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis |
| title_full | Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis |
| title_fullStr | Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis |
| title_full_unstemmed | Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis |
| title_short | Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis |
| title_sort | elevated troponin levels as a predictor of mortality in patients with acute stroke a systematic review and meta analysis |
| topic | troponin mortality acute stroke ischemic stroke intracerebral hemorrhage subarachnoid hemorrhage |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1351925/full |
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