Abstract Details

Title Prognostic Value of Cardiac Troponin I in Acute Ischemic Stroke Patients Treated with Thrombolytic Therapy: A Multicenter Retrospective Cohort Study.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-021

Objective NA

Background Cardiac troponin is a well-established diagnostic and prognostic marker in coronary heart disease. We investigated its prognostic value in acute ischemic stroke (AIS) patients treated with thrombolytic therapy.

Design/Methods We conducted a multicenter retrospective observational study of AIS patients treated with thrombolytics at The University of Oklahoma and Southern Illinois Healthcare (2017-2024). Demographics, clinical, laboratory, and radiographic data were collected. Cardiac troponin I (cTnI) on admission and subsequent values during the same hospitalization were reviewed. Patients were divided by admission cTnI levels. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and mRS at 30 days (good outcome was defined as mRS ≤ 2). Multivariable logistic regression was used to evaluate the association between cTnI and predetermined outcomes. Statistical significance was set at p<0.05.

Results Of 496 patients included in the study, 143 (29%) had elevated cTnI. Compared to patients with normal cTnI, those with elevated levels were older (75 [64-84] vs. 65 [54-76] years), had higher rate of hypertension (83% vs. 71%), diabetes (37% vs. 27%), cardiac diseases (51% vs. 29%), and higher initial NIHSS (11 [5-17] vs. 7 [4-13]). After adjustment for age, preexistent cardiac disease, baseline mRS, and NIHSS, logistic regression revealed that elevated cTnI remained independently associated with development of sICH (OR: 3.667, 95%CI: 1.105-12.161, p=0.034), higher odds of in-hospital mortality (OR: 2.277, 95%CI: 1.052-4.925, p=0.037), and lower likelihood of good short-term functional outcome (OR: 0.425, 95%CI: 0.26-0.693, p<0.001). Normalization of cardiac enzymes did not translate into improvement in survival (p>0.05).

Conclusions In our study, elevation of cardiac enzymes at presentation was an independent factor associated with an increased risk of sICH and an unmodifiable predictor of worse short-term outcomes in AIS patients treated with thrombolytic therapy.

Authors/Disclosures
Kaitlyn Pixley PRESENTER	Miss Pixley has nothing to disclose.
Andrea Loggini, MD, MPH MBA (Southern Illinois Healthcare)	Dr. Loggini has nothing to disclose.
Heather A. von Hagn, RN	Ms. von Hagn has nothing to disclose.
Laura Boada Robayo, MD	Laura Boada Robayo, MD has nothing to disclose.
Ayesha Sajid, MD	Miss Sajid has nothing to disclose.
Trace Lawson	Mr. Lawson has nothing to disclose.
Jonatan Hornik, MD (The University of Chicago, Dept of Neurology)	Dr. Hornik has nothing to disclose.
Amber Schwertman	Mrs. Schwertman has nothing to disclose.
Karam Dallow, MD	Dr. Dallow has nothing to disclose.
Alejandro Hornik, MD (SIH)	Dr. Hornik has nothing to disclose.
Camila Bonin Pinto (Oklahoma University)	Camila Bonin Pinto has nothing to disclose.
Faddi G. Saleh Velez, MD (University of oklahoma health Sciences center)	Dr. Saleh Velez has nothing to disclose.

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