title: Elevated Cardiac Troponin in Acute Stroke without Acute Coronary Syndrome Predicts Long-Term Adverse Cardiovascular Outcomes.
abstract: Background. Elevated cardiac troponin in acute stroke in absence of acute coronary syndrome (ACS) has unclear long-term outcomes. Methods. Retrospective analysis of 566 patients admitted to Temple University Hospital from 2008 to 2010 for acute stroke was performed. Patients were included if cardiac troponin I was measured and had no evidence of ACS and an echocardiogram was performed. Of 200 patients who met the criteria, baseline characteristics, electrocardiograms, and major adverse cardiovascular events (MACE) were reviewed. Patients were characterized into two groups with normal and elevated troponins. Primary end point was nonfatal myocardial infarction during follow-up period after discharge. The secondary end points were MACE and death from any cause. Results. For 200 patients, 17 patients had positive troponins. Baseline characteristics were as follows: age 63.1 ± 13.8, 64% African Americans, 78% with hypertension, and 22% with previous CVA. During mean follow-up of 20.1 months, 7 patients (41.2%) in elevated troponin and 6 (3.3%) patients in normal troponin group had nonfatal myocardial infarction (P = 0.0001). MACE (41.2% versus 14.2%, P = 0.01) and death from any cause (41.2% versus 14.5%, P = 0.017) were significant in the positive troponin group. Conclusions. Elevated cardiac troponin in patients with acute stroke and no evidence of ACS is strong predictor of long-term cardiac outcomes.
authors.affiliation: Department of Medicine Cardiology Section, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: Farhan
authors.identifier: 0000-0001-5750-2034
authors.initials: F
authors.lastname: Raza
authors.affiliation: Department of Medicine Cardiology Section, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: Mohamad
authors.identifier: 0000-0003-3847-0959
authors.initials: M
authors.lastname: Alkhouli
authors.affiliation: Temple University School of Medicine, Philadelphia, PA 19140, USA.
authors.forename: Paul
authors.identifier: 0000-0002-6319-4274
authors.initials: P
authors.lastname: Sandhu
authors.affiliation: Department of Medicine, Internal Medicine Section, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: Reema
authors.initials: R
authors.lastname: Bhatt
authors.affiliation: Department of Medicine Cardiology Section, Temple University Hospital, Philadelphia, PA 19140, USA ; Temple University School of Medicine, Philadelphia, PA 19140, USA.
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bove