Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke

Peter Csecsei, Gabriella Pusch, Erzsebet Ezer, Timea Berki, Laszlo Szapary, Zsolt Illes, Tihamer Molnar

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: In patients with acute ischemic stroke (AIS) without cardiovascular complications, we investigated the association of serum concentration of cardiac troponin (high-sensitivity cardiac troponin T [hs-cTnT]) with thrombo-inflammatory markers.

METHODS: Thirty-five patients with first-ever AIS were prospectively examined. Serum hs-cTnT was measured 6 and 24 hours after stroke, whereas S100B, high-sensitivity C-reactive protein (hsCRP), soluble CD40 ligand, tissue plasminogen activator (tPA), monocyte chemoattractant protein-1 (MCP-1), and P-selectin were measured 6 and 72 hours after stroke. Severity of stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS) on admission, 24 hours later, and at discharge.

RESULTS: Concentration of MCP-1 at 6 hours was higher in the serum of patients with worsened NIHSS by 24 hours (P = .009). Concentration of hs-cTnT at both 6 and 24 hours was higher, if NIHSS worsened by discharge (P = .026 and P = .001). A cutoff value for hs-cTnT measured at T24 greater than or equal to  9.4 predicted worsened NIHSS on discharge with a sensitivity of 81% and a specificity of 74% (area: .808, P = .002). Concentration of hs-cTnT at both 6 and 24 hours was also higher in nonsurvivors compared with survivors (P = .03, respectively), and correlated with (1) tPA levels at 6 hours (P = .001 and P = .002, respectively); (2) MCP-1 concentration at 6 hours (P = .01 and P = .015, respectively); and increased hsCRP levels at 72 hours (P = .01, respectively). Concentration of hs-cTnT at 24 hours was an independent predictor of worsened NIHSS at discharge (odds ratio: 1.58, 95% confidence interval: 1.063-2.370, P = .024).

CONCLUSIONS: Elevated concentration of hs-cTnT measured 24 hours after AIS is an independent predictor of progressing neurologic deficit in patients without apparent myocardial damage, and also correlates with acute elevation of tPA and MCP-1.

Original languageEnglish
JournalJournal of Stroke & Cerebrovascular Diseases
Volume27
Issue number4
Pages (from-to)951-956
ISSN1052-3057
DOIs
Publication statusPublished - Apr 2018

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Troponin T
Chemokine CCL2
Tissue Plasminogen Activator
Serum
CD40 Ligand
P-Selectin
Survivors
Odds Ratio
Confidence Intervals

Keywords

  • Journal Article
  • Acute ischemic stroke
  • monocyte chemoattractant protein-1
  • high-sensitivity troponin t
  • S100B
  • outcome
  • Predictive Value of Tests
  • Up-Regulation
  • Prognosis
  • Prospective Studies
  • Humans
  • Middle Aged
  • Male
  • Time Factors
  • Aged, 80 and over
  • Adult
  • Biomarkers/blood
  • Female
  • Stroke/blood
  • Odds Ratio
  • Disability Evaluation
  • Chemokine CCL2/blood
  • Risk Factors
  • Logistic Models
  • Chi-Square Distribution
  • Inflammation Mediators/blood
  • Tissue Plasminogen Activator/blood
  • Brain Ischemia/blood
  • Aged
  • Troponin T/blood

Cite this

Csecsei, Peter ; Pusch, Gabriella ; Ezer, Erzsebet ; Berki, Timea ; Szapary, Laszlo ; Illes, Zsolt ; Molnar, Tihamer. / Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke. In: Journal of Stroke & Cerebrovascular Diseases. 2018 ; Vol. 27, No. 4. pp. 951-956.
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title = "Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke",
abstract = "BACKGROUND: In patients with acute ischemic stroke (AIS) without cardiovascular complications, we investigated the association of serum concentration of cardiac troponin (high-sensitivity cardiac troponin T [hs-cTnT]) with thrombo-inflammatory markers.METHODS: Thirty-five patients with first-ever AIS were prospectively examined. Serum hs-cTnT was measured 6 and 24 hours after stroke, whereas S100B, high-sensitivity C-reactive protein (hsCRP), soluble CD40 ligand, tissue plasminogen activator (tPA), monocyte chemoattractant protein-1 (MCP-1), and P-selectin were measured 6 and 72 hours after stroke. Severity of stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS) on admission, 24 hours later, and at discharge.RESULTS: Concentration of MCP-1 at 6 hours was higher in the serum of patients with worsened NIHSS by 24 hours (P = .009). Concentration of hs-cTnT at both 6 and 24 hours was higher, if NIHSS worsened by discharge (P = .026 and P = .001). A cutoff value for hs-cTnT measured at T24 greater than or equal to  9.4 predicted worsened NIHSS on discharge with a sensitivity of 81{\%} and a specificity of 74{\%} (area: .808, P = .002). Concentration of hs-cTnT at both 6 and 24 hours was also higher in nonsurvivors compared with survivors (P = .03, respectively), and correlated with (1) tPA levels at 6 hours (P = .001 and P = .002, respectively); (2) MCP-1 concentration at 6 hours (P = .01 and P = .015, respectively); and increased hsCRP levels at 72 hours (P = .01, respectively). Concentration of hs-cTnT at 24 hours was an independent predictor of worsened NIHSS at discharge (odds ratio: 1.58, 95{\%} confidence interval: 1.063-2.370, P = .024).CONCLUSIONS: Elevated concentration of hs-cTnT measured 24 hours after AIS is an independent predictor of progressing neurologic deficit in patients without apparent myocardial damage, and also correlates with acute elevation of tPA and MCP-1.",
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author = "Peter Csecsei and Gabriella Pusch and Erzsebet Ezer and Timea Berki and Laszlo Szapary and Zsolt Illes and Tihamer Molnar",
note = "Copyright {\circledC} 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.",
year = "2018",
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language = "English",
volume = "27",
pages = "951--956",
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Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke. / Csecsei, Peter; Pusch, Gabriella; Ezer, Erzsebet; Berki, Timea; Szapary, Laszlo; Illes, Zsolt; Molnar, Tihamer.

In: Journal of Stroke & Cerebrovascular Diseases, Vol. 27, No. 4, 04.2018, p. 951-956.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke

AU - Csecsei, Peter

AU - Pusch, Gabriella

AU - Ezer, Erzsebet

AU - Berki, Timea

AU - Szapary, Laszlo

AU - Illes, Zsolt

AU - Molnar, Tihamer

N1 - Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: In patients with acute ischemic stroke (AIS) without cardiovascular complications, we investigated the association of serum concentration of cardiac troponin (high-sensitivity cardiac troponin T [hs-cTnT]) with thrombo-inflammatory markers.METHODS: Thirty-five patients with first-ever AIS were prospectively examined. Serum hs-cTnT was measured 6 and 24 hours after stroke, whereas S100B, high-sensitivity C-reactive protein (hsCRP), soluble CD40 ligand, tissue plasminogen activator (tPA), monocyte chemoattractant protein-1 (MCP-1), and P-selectin were measured 6 and 72 hours after stroke. Severity of stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS) on admission, 24 hours later, and at discharge.RESULTS: Concentration of MCP-1 at 6 hours was higher in the serum of patients with worsened NIHSS by 24 hours (P = .009). Concentration of hs-cTnT at both 6 and 24 hours was higher, if NIHSS worsened by discharge (P = .026 and P = .001). A cutoff value for hs-cTnT measured at T24 greater than or equal to  9.4 predicted worsened NIHSS on discharge with a sensitivity of 81% and a specificity of 74% (area: .808, P = .002). Concentration of hs-cTnT at both 6 and 24 hours was also higher in nonsurvivors compared with survivors (P = .03, respectively), and correlated with (1) tPA levels at 6 hours (P = .001 and P = .002, respectively); (2) MCP-1 concentration at 6 hours (P = .01 and P = .015, respectively); and increased hsCRP levels at 72 hours (P = .01, respectively). Concentration of hs-cTnT at 24 hours was an independent predictor of worsened NIHSS at discharge (odds ratio: 1.58, 95% confidence interval: 1.063-2.370, P = .024).CONCLUSIONS: Elevated concentration of hs-cTnT measured 24 hours after AIS is an independent predictor of progressing neurologic deficit in patients without apparent myocardial damage, and also correlates with acute elevation of tPA and MCP-1.

AB - BACKGROUND: In patients with acute ischemic stroke (AIS) without cardiovascular complications, we investigated the association of serum concentration of cardiac troponin (high-sensitivity cardiac troponin T [hs-cTnT]) with thrombo-inflammatory markers.METHODS: Thirty-five patients with first-ever AIS were prospectively examined. Serum hs-cTnT was measured 6 and 24 hours after stroke, whereas S100B, high-sensitivity C-reactive protein (hsCRP), soluble CD40 ligand, tissue plasminogen activator (tPA), monocyte chemoattractant protein-1 (MCP-1), and P-selectin were measured 6 and 72 hours after stroke. Severity of stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS) on admission, 24 hours later, and at discharge.RESULTS: Concentration of MCP-1 at 6 hours was higher in the serum of patients with worsened NIHSS by 24 hours (P = .009). Concentration of hs-cTnT at both 6 and 24 hours was higher, if NIHSS worsened by discharge (P = .026 and P = .001). A cutoff value for hs-cTnT measured at T24 greater than or equal to  9.4 predicted worsened NIHSS on discharge with a sensitivity of 81% and a specificity of 74% (area: .808, P = .002). Concentration of hs-cTnT at both 6 and 24 hours was also higher in nonsurvivors compared with survivors (P = .03, respectively), and correlated with (1) tPA levels at 6 hours (P = .001 and P = .002, respectively); (2) MCP-1 concentration at 6 hours (P = .01 and P = .015, respectively); and increased hsCRP levels at 72 hours (P = .01, respectively). Concentration of hs-cTnT at 24 hours was an independent predictor of worsened NIHSS at discharge (odds ratio: 1.58, 95% confidence interval: 1.063-2.370, P = .024).CONCLUSIONS: Elevated concentration of hs-cTnT measured 24 hours after AIS is an independent predictor of progressing neurologic deficit in patients without apparent myocardial damage, and also correlates with acute elevation of tPA and MCP-1.

KW - Journal Article

KW - Acute ischemic stroke

KW - monocyte chemoattractant protein-1

KW - high-sensitivity troponin t

KW - S100B

KW - outcome

KW - Predictive Value of Tests

KW - Up-Regulation

KW - Prognosis

KW - Prospective Studies

KW - Humans

KW - Middle Aged

KW - Male

KW - Time Factors

KW - Aged, 80 and over

KW - Adult

KW - Biomarkers/blood

KW - Female

KW - Stroke/blood

KW - Odds Ratio

KW - Disability Evaluation

KW - Chemokine CCL2/blood

KW - Risk Factors

KW - Logistic Models

KW - Chi-Square Distribution

KW - Inflammation Mediators/blood

KW - Tissue Plasminogen Activator/blood

KW - Brain Ischemia/blood

KW - Aged

KW - Troponin T/blood

U2 - 10.1016/j.jstrokecerebrovasdis.2017.10.040

DO - 10.1016/j.jstrokecerebrovasdis.2017.10.040

M3 - Journal article

C2 - 29249591

VL - 27

SP - 951

EP - 956

JO - Journal of Stroke & Cerebrovascular Diseases

JF - Journal of Stroke & Cerebrovascular Diseases

SN - 1052-3057

IS - 4

ER -