In:
European Stroke Journal, SAGE Publications, Vol. 7, No. 4 ( 2022-12), p. 413-420
Abstract:
Myocardial injury as indicated by elevation of cardiac troponin levels is common after acute ischemic stroke (AIS) and linked to poor outcomes. Previous studies rarely reported on serial hs-cTn measurements to distinguish whether myocardial injury is acute or chronic. Thus, little is known about frequency, associated variables, and outcome of acute myocardial injury in AIS. Methods and patients: In this single-centered observational cohort study, from 01/2019 to 12/2020, consecutive patients with neuroimaging-confirmed AIS 〈 48 h after symptom onset, and serial troponin measurements within the first 2 days after admission (Roche Elecsys ® , hs-cardiac troponin T) were prospectively registered. Acute myocardial injury was defined according to the fourth Universal Definition of Myocardial Infarction (troponin above the upper reference limit and rise/fall 〉 20%). Outcomes of interest were in-hospital mortality and unfavorable functional status at discharge (modified Rankin Scale 〉 1). Results: Out of 1067 analyzed patients, 25.3% had acute myocardial injury, 40.4% had chronic myocardial injury and 34.3% had no myocardial injury. Older age, higher stroke severity, thrombolytic treatment, and impaired kidney function were independently associated with acute myocardial injury. In-hospital mortality was higher in patients with acute myocardial injury than in those without (13% vs 3%, adjusted OR, 2.9% [95% CI, 1.6–5.5]). Compared with no myocardial injury, both acute and chronic myocardial injury were associated with unfavorable functional status at di scharge (adjusted OR, 1.6 [95% CI, 1.1–2.5] and OR, 1.7 [95% CI, 1.2–2.4] , respectively). Conclusions: A quarter of patients with AIS have evidence of acute myocardial injury according to the fourth Universal Definition of Myocardial Infarction. The strong association with in-hospital mortality highlights the need for clinical awareness and future studies on underlying mechanisms.
Type of Medium:
Online Resource
ISSN:
2396-9873
,
2396-9881
DOI:
10.1177/23969873221120159
Language:
English
Publisher:
SAGE Publications
Publication Date:
2022
detail.hit.zdb_id:
2851287-X
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