Objective

To evaluate the prognostic significance of high-sensitivity cardiac troponin T (hs-cTnT) elevation in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) in the anterior circulation treated with endovascular thrombectomy (ET) in late time windows and identify the factors associated with hs-cTnT elevation.

Methods

A total of 152 AIS patients treated with ET in late time windows between January 2018 and August 2020 were included in this study. Patients were stratified into either normal or elevated hs-cTnT groups according to a cutoff value of 14 ng/L on admission. Baseline demographic features, comorbidities, and imaging data were compared between the elevated hs-cTnT group (＞14 ng/L) and the normal hs-cTnT group (≤14 ng/L). After accounting for these clinical characteristics, the association between hs-cTnT elevation and clinical outcomes was evaluated.

Results

69(45.4%) patients had elevated hs-cTnT levels (>14 ng/L) on admission. The multivariable logistic regression analysis demonstrated that hs-cTnT elevation was independently associated with 3-month all-cause mortality (P = 0.014, OR 3.907, 95% CI 1.313–11.625) and 3-month composite unfavorable outcome (mRS 3–6) (P = 0.001, OR 5.099, 95% CI 1.873–13.888). Old age (P = 0.002, OR 1.053, 95% CI 1.020–1.088), admission NIHSS score (P = 0.015, OR 1.057, 95% CI 1.011–1.106), congestive heart failure (P = 0.016, OR 4.341, 95% CI 1.322–14.257) and coronary artery disease (P = 0.020, OR 2.914, 95% CI 1.183–7.180) were independently associated with hs-cTnT elevation.

Conclusion

In AIS patients treated with ET in late time windows, elevated hs-cTnT is independently associated with an increased risk of 3-month poor outcomes. Old age, high admission NIHSS score, coronary artery disease, and congestive heart failure are independent predictors of hs-cTnT elevation.

中文翻译：

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高敏心肌肌钙蛋白 T 升高对晚期窗口期血管内取栓治疗的急性缺血性卒中患者的预后价值

客观的

评估高敏心肌肌钙蛋白 T (hs-cTnT) 升高对前循环大血管闭塞 (LVO) 急性缺血性卒中 (AIS) 患者在晚期时间窗内接受血管内血栓切除术 (ET) 治疗的预后意义，并确定与 hs-cTnT 升高相关的因素。

方法

本研究共纳入了 152 名在 2018 年 1 月至 2020 年 8 月的后期窗口中接受 ET 治疗的 AIS 患者。根据入院时 14 ng/L 的临界值，将患者分为正常组或升高的 hs-cTnT 组。比较 hs-cTnT 升高组（＞14 ng/L）和 hs-cTnT 正常组（≤14 ng/L）的基线人口统计学特征、合并症和影像学数据。在考虑了这些临床特征后，评估了 hs-cTnT 升高与临床结果之间的关联。

结果

69 名（45.4%）患者入院时 hs-cTnT 水平升高（>14 ng/L）。多变量逻辑回归分析表明，hs-cTnT 升高与 3 个月全因死亡率（P = 0.014，OR 3.907，95% CI 1.313-11.625）和 3 个月复合不利结果（mRS 3-6）独立相关（P = 0.001，或 5.099，95% CI 1.873–13.888）。高龄 (P = 0.002, OR 1.053, 95% CI 1.020–1.088), 入院 NIHSS 评分 (P = 0.015, OR 1.057, 95% CI 1.011–1.106), 充血性心力衰竭 (P = 0.016, OR 4.341, 95% CI 1.322–14.257) 和冠状动脉疾病 (P = 0.020, OR 2.914, 95% CI 1.183–7.180) 与 hs-cTnT 升高独立相关。

结论

在晚期窗口期接受 ET 治疗的 AIS 患者中，升高的 hs-cTnT 与 3 个月不良结果的风险增加独立相关。高龄、高入院 NIHSS 评分、冠状动脉疾病和充血性心力衰竭是 hs-cTnT 升高的独立预测因素。