Skip to main content

Advertisement

Log in

Increased High-Sensitivity Troponin-T Levels Are Associated with Mortality After Ischemic Stroke

  • Published:
Journal of Molecular Neuroscience Aims and scope Submit manuscript

Abstract

Biomarkers for diagnosis, treatment, and outcome prediction after stroke are lacking. Therefore, we aimed to evaluate the association between increased serum troponin, stroke severity, and mortality. Unselected patients with acute ischemic stroke assessed for troponin levels were included over the span of 1 year. Risk-factor profile, stroke etiology, stroke severity, and mortality during acute admission were recorded. The study included 212 patients, and 35 had increased troponin levels. Elevated troponin levels were associated with older age (82.1 ± 10.7 vs. 72.2 ± 12.6, p < 0.001), poor kidney function (calculated GFR 58.7 ± 29.8 vs. 82.7 ± 28.4, p < 0.001), and known ischemic heart disease (51.4 % vs. 33.9 %, p = 0.049). Patients with increased troponin had increased stroke severity on admission (National Institutes of Health Stroke Scale (NIHSS) 16.0 ± 9.4 vs. 10.4 ± 8.0, p < 0.001). This association remained significant after multivariate analysis but was nonlinear. Mortality rates were significantly higher in patients with increased troponin (37.1 vs. 5.6 %, p < 0.001). On multivariate analysis, elevated troponin (odds ratio [OR] 22.57, 95 % CI 4.4–116.6), absence of ischemic heart disease (OR 10.3, 95 % CI 1.8–57.6), and admission NIHSS score (OR 1.59 for every 5 points, 95 % CI 1.1–2.4) were associated with mortality. This study indicates that elevated troponin is an independent marker for severe deficits on presentation and for mortality in stroke patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Adams HP Jr, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke J Cereb Circ 24:35–41

    Article  Google Scholar 

  • Agewall S, Giannitsis E, Jernberg T, Katus H (2011) Troponin elevation in coronary vs. non-coronary disease. Eur Heart J 32:404–411

    Article  CAS  PubMed  Google Scholar 

  • Akhter S, Zhang Z, Jin JP (2012) The heart-specific NH2-terminal extension regulates the molecular conformation and function of cardiac troponin I. Am J Physiol Heart Circ Physiol 302:H923–H933

    Article  CAS  PubMed  Google Scholar 

  • Beaulieu-Boire I, Leblanc N, Berger L, Boulanger JM (2013) Troponin elevation predicts atrial fibrillation in patients with stroke or transient ischemic attack. J Stroke Cereb Dis Off J Natl Stroke Assoc 22:978–983

    Google Scholar 

  • Chen C, Liu JB, Bian ZP et al (2014) Cardiac troponin I is abnormally expressed in non-small cell lung cancer tissues and human cancer cells. Int J Clin Exp Pathol 7:1314–1324

    PubMed  PubMed Central  Google Scholar 

  • Faiz KW, Thommessen B, Einvik G, Brekke PH, Omland T, Ronning OM (2014a) Determinants of high sensitivity cardiac troponin T elevation in acute ischemic stroke. BMC Neurol 14:96

    Article  PubMed  PubMed Central  Google Scholar 

  • Faiz KW, Thommessen B, Einvik G, Omland T, Ronning OM (2014b) Prognostic value of high-sensitivity cardiac troponin T in acute ischemic stroke. J Stroke Cereb Dis Off J Natl Stroke Assoc 23:241–248

    Google Scholar 

  • Filipczyk AA, Passier R, Rochat A, Mummery CL (2007) Regulation of cardiomyocyte differentiation of embryonic stem cells by extracellular signalling. Cell Mol Life Sci CMLS 64:704–718

    Article  CAS  PubMed  Google Scholar 

  • Fonarow GC, Pan W, Saver JL et al (2012) Comparison of 30-day mortality models for profiling hospital performance in acute ischemic stroke with vs without adjustment for stroke severity. JAMA 308:257–264

    Article  CAS  PubMed  Google Scholar 

  • Harlan SM, Reiter RS, Sigmund CD, Lin JL, Lin JJ (2008) Requirement of TCTG(G/C) direct repeats and overlapping GATA site for maintaining the cardiac-specific expression of cardiac troponin T in developing and adult mice. Anat Rec 291:1574–1586

    Article  CAS  Google Scholar 

  • Hijazi Z, Siegbahn A, Andersson U et al (2014) High-sensitivity troponin I for risk assessment in patients with atrial fibrillation: insights from the apixaban for reduction in stroke and other thromboembolic events in atrial fibrillation (ARISTOTLE) trial. Circulation 129:625–634

    Article  CAS  PubMed  Google Scholar 

  • Kerr G, Ray G, Wu O, Stott DJ, Langhorne P (2009) Elevated troponin after stroke: a systematic review. Cerebrovasc Dis 28:220–226

    Article  CAS  PubMed  Google Scholar 

  • Lyckman AW, Horng S, Leamey CA et al (2008) Gene expression patterns in visual cortex during the critical period: synaptic stabilization and reversal by visual deprivation. Proc Natl Acad Sci U S A 105:9409–9414

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Masuda T, Sato K, Yamamoto S et al (2002) Sympathetic nervous activity and myocardial damage immediately after subarachnoid hemorrhage in a unique animal model. Stroke J Cereb Circ 33:1671–1676

    Article  Google Scholar 

  • Oluleye OW, Folsom AR, Nambi V, Lutsey PL, Ballantyne CM, Investigators AS (2013) Troponin T, B-type natriuretic peptide, C-reactive protein, and cause-specific mortality. Ann Epidemiol 23:66–73

    Article  PubMed  Google Scholar 

  • Reeves MJ, Fonarow GC, Smith EE et al (2012) Representativeness of the get with the guidelines-stroke registry: comparison of patient and hospital characteristics among Medicare beneficiaries hospitalized with ischemic stroke. Stroke J Cereb Circ 43:44–49

    Article  Google Scholar 

  • Song HS, Back JH, Jin DK et al (2008) Cardiac troponin T elevation after stroke: relationships between elevated serum troponin T, stroke location, and prognosis. J Clin Neurol 4:75–83

    Article  PubMed  PubMed Central  Google Scholar 

  • Whiteley W, Chong WL, Sengupta A, Sandercock P (2009) Blood markers for the prognosis of ischemic stroke: a systematic review. Stroke J Cereb Circ 40:e380–e389

    Article  Google Scholar 

Download references

Sources of Funding

This study was supported by the Peritz and Chantal Scheinberg Cerebrovascular Research Fund and by the Sol Irwin Juni Trust Fund.

Conflict of Interest

All authors have nothing to disclose

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronen R. Leker.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maoz, A., Rosenberg, S. & Leker, R.R. Increased High-Sensitivity Troponin-T Levels Are Associated with Mortality After Ischemic Stroke. J Mol Neurosci 57, 160–165 (2015). https://doi.org/10.1007/s12031-015-0593-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12031-015-0593-7

Keywords

Navigation