Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke
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 lon...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Stroke Society
2017-09-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2016-01942.pdf |
| _version_ | 1828431206526484480 |
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| author | Sung-Ho Ahn Ji-Sung Lee Young-Hak Kim Bum Joon Kim Yeon-Jung Kim Dong-Wha Kang Jong S. Kim Sun U. Kwon |
| author_facet | Sung-Ho Ahn Ji-Sung Lee Young-Hak Kim Bum Joon Kim Yeon-Jung Kim Dong-Wha Kang Jong S. Kim Sun U. Kwon |
| author_sort | Sung-Ho Ahn |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T17:59:39Z |
| format | Article |
| id | doaj.art-cbbc8e6c16cc4230ad0d856353bd7c0f |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-12-10T17:59:39Z |
| publishDate | 2017-09-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-cbbc8e6c16cc4230ad0d856353bd7c0f2022-12-22T01:38:50ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052017-09-0119331232210.5853/jos.2016.01942191Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic StrokeSung-Ho Ahn0Ji-Sung Lee1Young-Hak Kim2Bum Joon Kim3Yeon-Jung Kim4Dong-Wha Kang5Jong S. Kim6Sun U. Kwon7 Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Clinical Research Center, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Division of Cardiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Neurology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, KoreaBackground 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.http://www.j-stroke.org/upload/pdf/jos-2016-01942.pdfstrokeprognosistroponin |
| spellingShingle | Sung-Ho Ahn Ji-Sung Lee Young-Hak Kim Bum Joon Kim Yeon-Jung Kim Dong-Wha Kang Jong S. Kim Sun U. Kwon Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke Journal of Stroke stroke prognosis troponin |
| title | Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke |
| title_full | Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke |
| title_fullStr | Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke |
| title_full_unstemmed | Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke |
| title_short | Prognostic Significance of Troponin Elevation for Long-Term Mortality after Ischemic Stroke |
| title_sort | prognostic significance of troponin elevation for long term mortality after ischemic stroke |
| topic | stroke prognosis troponin |
| url | http://www.j-stroke.org/upload/pdf/jos-2016-01942.pdf |
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