Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation
Ki‐Woong Nam, Chi Kyung Kim, Sungwook Yu, Jong‐Won Chung, Oh Young Bang, Gyeong‐Moon Kim, Jin‐Man Jung, Tae-Jin Song, Yong‐Jae Kim, Bum Joon Kim, Sung Hyuk Heo, Kwang‐Yeol Park, Jeong‐Min Kim, Jong‐Ho Park, Jay Chol Choi, Man‐Seok Park, Joon‐Tae Kim, Kang‐Ho Choi, Yang Ha Hwang, Woo‐Keun Seo, Kyungmi Oh
Abstract
Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR) = 1.16, 95% confidence interval (CI) 1.00-1.34; P = 0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR = 1.03, 95% CI 1.00-1.06; P = 0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR = 0.35, 95% CI 0.23-0.54; P < 0.001) and new oral anticoagulants (aOR = 0.41, 95% CI 0.19-0.89; P = 0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.