Association Between Troponin Levels and Visceral Infarction in Patients with Acute Ischemic Stroke.
Publication/Presentation Date
12-1-2019
Abstract
BACKGROUND: Visceral infarctions appear to be more common in patients with embolic stroke subtypes, but their relation to troponin elevation remains uncertain.
METHODS: Among patients with acute ischemic stroke enrolled in the Cornell AcutE Stroke Academic Registry (CAESAR) from 2011 to 2016, we included those with troponin measured within 24 hours from stroke onset and a contrast-enhanced abdominal computed tomographic scan within 1 year of admission. A troponin elevation was defined as a value exceeding our laboratory's upper limit of normal (.04 ng/ mL) in the absence of a clinically recognized acute ST-segment elevation myocardial infarction. Visceral infarction was defined as a renal or splenic infarction as ascertained by a single radiologist blinded to patients' other characteristics. Multivariable logistic regression was used to evaluate the association between elevated troponin and visceral infarction.
RESULTS: Among 2116 patients registered in CAESAR from 2011 to 2016, 153 patients had both a troponin assay and a contrast-enhanced abdominal computed tomographic scan, of whom 33 (21%) had an elevated troponin and 22 (14%) had a visceral infarction. The prevalence of visceral infarction was higher among patients with an elevated troponin (30%; 95% confidence interval [CI], 16%-49%) than among patients without an elevated troponin (10%; 95% CI, 5%-17%) (P = .003). After adjustment for demographics and comorbidities, we found a significant association between elevated troponin and visceral infarction (odds ratio, 3.9; 95% CI, 1.5-10.4).
CONCLUSIONS: Among patients with acute ischemic stroke, elevated troponin was associated with visceral infarction. Our results demonstrate that poststroke troponin elevation may indicate the presence of underlying embolic sources.
Volume
28
Issue
12
First Page
104449
Last Page
104449
ISSN
1532-8511
Published In/Presented At
Ramasamy, S., Patel, P., Gupta, A., Okin, P. M., Murthy, S., Navi, B. B., Kamel, H., & Merkler, A. E. (2019). Association Between Troponin Levels and Visceral Infarction in Patients with Acute Ischemic Stroke. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 28(12), 104449. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104449
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
31668582
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article