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BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Stroke | Research article

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

Authors: Felipe A. Montellano, Elisabeth J. Kluter, Viktoria Rücker, Kathrin Ungethüm, Daniel Mackenrodt, Silke Wiedmann, Tassilo Dege, Anika Quilitzsch, Caroline Morbach, Stefan Frantz, Stefan Störk, Karl Georg Haeusler, Christoph Kleinschnitz, Peter U. Heuschmann

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background

Troponin 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.

Methods

Data 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.

Results

We 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.

Conclusion

Cardiac 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.
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Metadata
Title
Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study
Authors
Felipe A. Montellano
Elisabeth J. Kluter
Viktoria Rücker
Kathrin Ungethüm
Daniel Mackenrodt
Silke Wiedmann
Tassilo Dege
Anika Quilitzsch
Caroline Morbach
Stefan Frantz
Stefan Störk
Karl Georg Haeusler
Christoph Kleinschnitz
Peter U. Heuschmann
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-03017-1

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