Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation

Ki Woong Nam; Chi Kyung Kim; Sungwook Yu; Jong Won Chung; Oh Young Bang; Gyeong Moon Kim; Jin Man Jung; Tae Jin Song; Yong Jae Kim; Bum Joon Kim; Sung Hyuk Heo; Kwang Yeol Park; Jeong Min Kim; Jong Ho Park; Jay Chol Choi; Man Seok Park; Joon Tae Kim; Kang Ho Choi; Yang Ha Hwang; Woo Keun Seo; Kyungmi Oh

doi:10.1038/s41598-020-69303-5

Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation

Ki Woong Nam, Chi Kyung Kim, Sungwook Yu, Jong Won Chung, Oh Young Bang, Gyeong Moon Kim, Jin Man Jung, Tae Jin Song, Yong Jae Kim, Bum Joon Kim, Sung Hyuk Heo, Kwang Yeol Park, Jeong Min Kim, Jong Ho Park, Jay Chol Choi, Man Seok Park, Joon Tae Kim, Kang Ho Choi, Yang Ha Hwang, Woo Keun SeoKyungmi Oh

Department of Neurology

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR) = 1.16, 95% confidence interval (CI) 1.00–1.34; P = 0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR = 1.03, 95% CI 1.00–1.06; P = 0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR = 0.35, 95% CI 0.23–0.54; P < 0.001) and new oral anticoagulants (aOR = 0.41, 95% CI 0.19–0.89; P = 0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.

Original language	English
Article number	12626
Journal	Scientific Reports
Volume	10
Issue number	1
DOIs	https://doi.org/10.1038/s41598-020-69303-5
State	Published - 1 Dec 2020

Bibliographical note

Funding Information:
The study was partially supported by the Korean Neurological Association (KNA-17-MI-10) and the National Research Foundation of Korea (NRF-2019R1A2C2008788).

Publisher Copyright:
© 2020, The Author(s).

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10.1038/s41598-020-69303-5

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Nam, K. W., Kim, C. K., Yu, S., Chung, J. W., Bang, O. Y., Kim, G. M., Jung, J. M., Song, T. J., Kim, Y. J., Kim, B. J., Heo, S. H., Park, K. Y., Kim, J. M., Park, J. H., Choi, J. C., Park, M. S., Kim, J. T., Choi, K. H., Hwang, Y. H., ... Oh, K. (2020). Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation. Scientific Reports, 10(1), Article 12626. https://doi.org/10.1038/s41598-020-69303-5

@article{aa5a9903cf524e37817b75507756ea53,

title = "Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation",

abstract = "Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR) = 1.16, 95% confidence interval (CI) 1.00–1.34; P = 0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR = 1.03, 95% CI 1.00–1.06; P = 0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR = 0.35, 95% CI 0.23–0.54; P < 0.001) and new oral anticoagulants (aOR = 0.41, 95% CI 0.19–0.89; P = 0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.",

author = "Nam, {Ki Woong} and Kim, {Chi Kyung} and Sungwook Yu and Chung, {Jong Won} and Bang, {Oh Young} and Kim, {Gyeong Moon} and Jung, {Jin Man} and Song, {Tae Jin} and Kim, {Yong Jae} and Kim, {Bum Joon} and Heo, {Sung Hyuk} and Park, {Kwang Yeol} and Kim, {Jeong Min} and Park, {Jong Ho} and Choi, {Jay Chol} and Park, {Man Seok} and Kim, {Joon Tae} and Choi, {Kang Ho} and Hwang, {Yang Ha} and Seo, {Woo Keun} and Kyungmi Oh",

note = "Funding Information: The study was partially supported by the Korean Neurological Association (KNA-17-MI-10) and the National Research Foundation of Korea (NRF-2019R1A2C2008788). Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2020",

month = dec,

day = "1",

doi = "10.1038/s41598-020-69303-5",

language = "English",

volume = "10",

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Nam, KW, Kim, CK, Yu, S, Chung, JW, Bang, OY, Kim, GM, Jung, JM, Song, TJ, Kim, YJ, Kim, BJ, Heo, SH, Park, KY, Kim, JM, Park, JH, Choi, JC, Park, MS, Kim, JT, Choi, KH, Hwang, YH, Seo, WK & Oh, K 2020, 'Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation', Scientific Reports, vol. 10, no. 1, 12626. https://doi.org/10.1038/s41598-020-69303-5

TY - JOUR

T1 - Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation

AU - Nam, Ki Woong

AU - Kim, Chi Kyung

AU - Yu, Sungwook

AU - Chung, Jong Won

AU - Bang, Oh Young

AU - Kim, Gyeong Moon

AU - Jung, Jin Man

AU - Song, Tae Jin

AU - Kim, Yong Jae

AU - Kim, Bum Joon

AU - Heo, Sung Hyuk

AU - Park, Kwang Yeol

AU - Kim, Jeong Min

AU - Park, Jong Ho

AU - Choi, Jay Chol

AU - Park, Man Seok

AU - Kim, Joon Tae

AU - Choi, Kang Ho

AU - Hwang, Yang Ha

AU - Seo, Woo Keun

AU - Oh, Kyungmi

N1 - Funding Information: The study was partially supported by the Korean Neurological Association (KNA-17-MI-10) and the National Research Foundation of Korea (NRF-2019R1A2C2008788). Publisher Copyright: © 2020, The Author(s).

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR) = 1.16, 95% confidence interval (CI) 1.00–1.34; P = 0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR = 1.03, 95% CI 1.00–1.06; P = 0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR = 0.35, 95% CI 0.23–0.54; P < 0.001) and new oral anticoagulants (aOR = 0.41, 95% CI 0.19–0.89; P = 0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.

AB - Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase ≥ 2 in the total NIHSS score or ≥ 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR) = 1.16, 95% confidence interval (CI) 1.00–1.34; P = 0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR = 1.03, 95% CI 1.00–1.06; P = 0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR = 0.35, 95% CI 0.23–0.54; P < 0.001) and new oral anticoagulants (aOR = 0.41, 95% CI 0.19–0.89; P = 0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.

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U2 - 10.1038/s41598-020-69303-5

DO - 10.1038/s41598-020-69303-5

M3 - Article

C2 - 32724110

AN - SCOPUS:85088636022

SN - 2045-2322

VL - 10

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 12626

ER -

Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation

Abstract

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