Abstract Details

Title Serum Troponin Level In Acute Ischemic Stroke Identifies Patients with Concomitant Visceral Infarcts

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-030

Objective To determine the association between serum troponin level at time of stroke and visceral infarcts in an ischemic stroke cohort.

Background Patients with ischemic stroke of cardioembolic origin, are at risk of developing visceral (renal or splenic) infarcts.

Design/Methods Data was abstracted from a single center prospective ischemic stroke database over 18 months and included all patients with ischemic stroke who underwent a contrast enhanced CT abdomen and pelvis for clinical purposes within one year of stroke. The primary predictor was troponin level ≥ 0.1 ng/mL. The primary outcome was visceral infarct (renal and/or splenic) on CT abdomen and pelvis. Univariate and multivariable logistic regression models were used to estimate the odds ratio and 95% confidence intervals (OR, 95% CI) for the association of troponin with visceral infarct before and after adjusting for demographics and risk factors (hypertension, diabetes, hyperlipidemia, stroke history, congestive heart failure, coronary heart disease, and smoking), NIHSS score, and stroke subtype (cardioembolic, embolic stroke of unknown source, and defined non-cardioembolic subtypes).

Results Of 1234 patients with ischemic stroke, 259 patients had a qualifying visceral CT. Serum troponin level on admission was measured in 237 patients (93.3%). 25 patients with visceral infarcts: 16 renal, 7 splenic, and 2 both. In univariate models, there was an association between serum troponin level and the presence of visceral infarct (39.1% vs. 15.0%, p = 0.008) and it persisted in multivariable models (OR 3.65 95% CI 1.46 - 9.17, p = 0.006). Unsurprisingly, there was an association between visceral infarct and cardioembolic stroke subtype (OR 7.88 95% CI 1.01 – 61.87, p=0.05) and ESUS subtype (OR 7.55 95% CI 0.95 – 60.15, p = 0.056), when compared to non-cardioembolic stroke subtypes.

Conclusions In ischemic stroke patients, elevated serum troponin levels may help identify patients with concomitant visceral infarcts. Larger studies are needed to confirm our findings.

Authors/Disclosures
Aidan Azher, MD (UTHealth, McGovern School of Medicine) PRESENTER	Dr. Azher has nothing to disclose.
Ashutosh Kaushal, MD (UTHealth Neurosciences – Department of Neurology)	No disclosure on file
Andrew D. Chang, MS	No disclosure on file
Shawna M. Cutting, MD, FAAN	The institution of Dr. Cutting has received research support from Genentech.
Brian Mac Grory, MB BCh BAO (Duke University School of Medicine)	An immediate family member of Dr. Mac Grory has received personal compensation for serving as an employee of Sanofi. Dr. Mac Grory has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke. The institution of Dr. Mac Grory has received research support from National Institutes of Health. The institution of Dr. Mac Grory has received research support from American Heart Association.
Tina M. Burton, MD	Dr. Burton has nothing to disclose.
Katarina B. Dakay, DO	No disclosure on file
Bradford B. Thompson, MD (St. Elizabeth’s Medical Center)	Dr. Thompson has nothing to disclose.
Michael Reznik, MD (Rhode Island Hospital)	Dr. Reznik has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Morrison Mahoney. The institution of Dr. Reznik has received research support from NIDUS.
Linda C. Wendell, MD, FAAN (Mount Auburn Hospital)	Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. An immediate family member of Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Wendell has stock in Apple. An immediate family member of Dr. Wendell has stock in Apple.
Nicholas S. Potter, MD, PhD (Rhode Island Hospital)	Dr. Potter has nothing to disclose.
Ali Mahta, MD (Brown University)	Dr. Mahta has received research support from Brown University Health.
Alexander Merkler, MD	Dr. Merkler has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurohospitalist. Dr. Merkler has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for n/a.
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
Mahesh Jayaraman	No disclosure on file
	No disclosure on file
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ)	The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.

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