Abstract Details

Title Association Between Stroke Severity and Cardiac Troponins in Acute Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 102

Objective To evaluate the association between stroke severity and serum cardiac troponin levels in acute stroke.

Background Cardiac troponins are often elevated in patients with acute stroke and have been associated poor outcomes. Whether the elevation in troponins, a marker of acute myocardial injury, is due to neurogenic mechanisms or the underlying cardiac risk factors is unknown.

Design/Methods We conducted a retrospective study of adults (≥40 years) with a discharge diagnosis of imaging-confirmed stroke admitted to a quaternary stroke centre in Toronto, Canada between January 1, 2018-December 31, 2018. We collected demographic and clinical information, including stroke severity using the National Institutes of Health Stroke Scale [NIHSS]. We recorded serum cardiac troponin levels on admission. We modelled serum troponin level both as a continuous and a categorical variable (normal vs. high, ≥ 15 ng/L). We evaluated the association between admission NIHSS and serum troponin level using multivariable negative binomial models and logistic regression models, adjusting for demographics (age and sex) and comorbidities (history of congestive heart failure or stroke, stroke type [ischemic vs. hemorrhagic], ST elevation on ECG, and creatinine levels).

Results We included 218 patients with acute stroke (median age 76 years, 48.6% women, 87.2% ischemic stroke). Median NIHSS was 6 (Q1-Q3, 2-14), and median cardiac troponin level was 17 ng/L (Q1-Q3, 9-30), with 108 (53.2%) patients having higher than normal levels. A one-point increase in NIHSS was associated with a higher troponin level in age- and sex- (RR 1.03; 1.00-1.05) and multivariable- (RR 1.03; 1.01-1.05) adjusted models. However, stroke severity was not associated with the odds of having high troponin levels in adjusted models (OR 1.03; 0.98-1.08).

Conclusions The modest, yet independent, association between greater stroke severity and higher cardiac troponins in patients with acute stroke could suggest a neurogenic basis for mild cardiac injury in patients with acute stroke.

Authors/Disclosures
Andrea Kuczynski, MD, PhD PRESENTER	Dr. Kuczynski has nothing to disclose.
	No disclosure on file
	No disclosure on file
Petra Famiyeh	Miss Famiyeh has nothing to disclose.
Manav Vyas, MD (MV VYAS MEDICINE PROFESSIONAL CORPORATION)	The institution of Dr. Vyas has received research support from Heart and Stroke Foundation of Canada . The institution of Dr. Vyas has received research support from Canadian Institutes of Health Research . Dr. Vyas has received research support from Heart and Stroke Foundation of Canada .

��ɫ��

��ɫ��