Serial high-sensitivity troponin I monitoring as a prognostic marker in acute ischemic stroke

Abstract

Introduction and aim. Acute ischemic stroke (AIS) is a complex disease with multifactorial etiologies, often masking underlying cardiovascular morbidities that contribute to clinical outcomes. This study explored the role of serial high-sensitivity troponin I (hs-TnI) monitoring in AIS patients as a prognostic marker of cardiovascular morbidity and mortality. The results offer substantial information on the relationship between hs-TnI elevations and clinical, electrocardiographic (ECG), echocardiographic (ECHO), and angiographic parameters in patients with AIS. Material and methods. A prospective observational study was conducted on 60 patients with AIS in a tertiary care center, Tamil Nadu. Hs-TnI levels were measured at the time of admission and after 48 h together with ECG, ECHO. Angiographic evaluations were done in patients with elevated hs-TnI at 48 h after admission. Results. Among the study population, hs-TnI levels increased significantly from 11.7% at admission to 20% after 48 h (p=0.02).Logistic regression showed hs-TnI at 48 h predicted mortality (odds ratio [OR]=28.5, 95% confidence interval [CI]: 5.9‒137.1, p<0.001) and coronary artery disease (CAD) (OR=48.2, 95% CI: 9.8‒236.5, p<0.001). Conclusion. Serial monitoring of hs-TnI in AIS patients revealed its potential role in the identification of culprit lesions on coronary angiogram, which is correlated with the presence of CAD and mortality.