High-sensitivity cardiac troponin T levels and risk of cerebral microbleeds in acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease

J Neurol Sci. 2016 Oct 15:369:15-18. doi: 10.1016/j.jns.2016.08.003. Epub 2016 Aug 2.

Abstract

Background and objective: Elevated high-sensitivity cardiac troponin T (hs-cTnT) levels are associated with coronary disease and small-vessel ischemic stroke through their associations with atherosclerosis. Considering the relationship between atherosclerosis and cerebral microbleeds (CMBs), the purpose of this study was to examine associations between serum hs-cTnT levels and risk of CMBs in acute ischemic stroke patients.

Methods: This prospective study involved consecutively recruited acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease treated at a large tertiary care hospital in southwestern China. Clinico-demographic data were collected and analyzed by logistic regression to identify the relationship between serum hs-cTnT levels and CMB occurrence and location.

Results: In the final analysis, of 66 patients (27 males; mean age, 68.7years), 39 (59.1%) had CMBs. Hs-cTnT levels were not associated with risk of strictly lobar CMBs. However, after adjusting age, sex, current alcohol consumption, total cholesterol, hypertension, diabetes mellitus, prior antithrombotic therapy and NIHSS on admission, patients in the higher tertile were more likely to have CMBs and deep or infratentorial CMBs (P<0.05) compared with the lower hs-cTnT tertile.

Conclusion: Hs-cTnT may be an independent predictor for the occurrence of CMBs, particularly of deep or infratentorial CMBs. This finding justifies further research into how hs-cTnT levels may contribute to CMBs and potentially other subclinical small-vessel diseases.

Keywords: Acute ischemic stroke; Atrial fibrillation; Cardiac troponin T; Cerebral microbleeds; Rheumatic heart disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / blood*
  • Atrial Fibrillation / complications
  • Brain Ischemia / complications
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Rheumatic Heart Disease / blood*
  • Rheumatic Heart Disease / complications
  • Severity of Illness Index
  • Stroke / blood*
  • Stroke / complications
  • Stroke / etiology
  • Troponin T / blood*

Substances

  • Troponin T