Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study

BMC Neurology

Research Article

Stefan Frantz¹  Stefan Störk¹  Caroline Morbach¹  Christoph Kleinschnitz²  Karl Georg Haeusler³  Elisabeth J. Kluter⁴  Anika Quilitzsch⁴  Kathrin Ungethüm⁴  Tassilo Dege⁴  Silke Wiedmann⁴  Viktoria Rücker⁴  Peter U. Heuschmann⁵  Daniel Mackenrodt⁶  Felipe A. Montellano⁷ 

[1]Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany

[2]Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

[3]Department of Neurology and Center for Translational and Behavioral Neurosciences (C-TNBS), University Hospital Essen, Essen, Germany

[4]Department of Neurology, University Hospital Würzburg, Würzburg, Germany

[5]Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

[6]Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

[7]Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany

[8]Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany

[9]Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

[10]Department of Neurology, University Hospital Würzburg, Würzburg, Germany

[11]Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany

[12]Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany

[13]Interdisciplinary Center for Clinical Research, University Hospital Würzburg, Würzburg, Germany

[14]Department of Neurology, University Hospital Würzburg, Würzburg, Germany

[15]Comprehensive Heart Failure Center, University and University Hospital Würzburg, Würzburg, Germany

关键词: Ischemic stroke;    Troponin;    Heart failure;    Biomarkers;    Echocardiography;   

DOI  :  10.1186/s12883-022-03017-1

 received in 2022-02-16, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTroponin elevation is common in ischemic stroke (IS) patients. The pathomechanisms involved are incompletely understood and comprise coronary and non-coronary causes, e.g. autonomic dysfunction. We investigated determinants of troponin elevation in acute IS patients including markers of autonomic dysfunction, assessed by heart rate variability (HRV) time domain variables.MethodsData were collected within the Stroke Induced Cardiac FAILure (SICFAIL) cohort study. IS patients admitted to the Department of Neurology, Würzburg University Hospital, underwent baseline investigation including cardiac history, physical examination, echocardiography, and blood sampling. Four HRV time domain variables were calculated in patients undergoing electrocardiographic Holter monitoring. Multivariable logistic regression with corresponding odds ratios (OR) and 95% confidence intervals (CI) was used to investigate the determinants of high-sensitive troponin T (hs-TnT) levels ≥14 ng/L.ResultsWe report results from 543 IS patients recruited between 01/2014–02/2017. Of those, 203 (37%) had hs-TnT ≥14 ng/L, which was independently associated with older age (OR per year 1.05; 95% CI 1.02–1.08), male sex (OR 2.65; 95% CI 1.54–4.58), decreasing estimated glomerular filtration rate (OR per 10 mL/min/1.73 m2 0.71; 95% CI 0.61–0.84), systolic dysfunction (OR 2.79; 95% CI 1.22–6.37), diastolic dysfunction (OR 2.29; 95% CI 1.29–4.02), atrial fibrillation (OR 2.30; 95% CI 1.25–4.23), and increasing levels of C-reactive protein (OR 1.48 per log unit; 95% CI 1.22–1.79). We did not identify an independent association of troponin elevation with the investigated HRV variables.ConclusionCardiac dysfunction and elevated C-reactive protein, but not a reduced HRV as surrogate of autonomic dysfunction, were associated with increased hs-TnT levels in IS patients independent of established cardiovascular risk factors.Registration-URL: https://www.drks.de/drks_web/; Unique identifier: DRKS00011615.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 17

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