Cardiac biomarkers are associated with increased risks of adverse clinical outcomes after ischemic stroke

• Published in: Journal of neurology 2024-09, Vol.271 (9), p.6313-6324
• Main Authors: Chang, Xinyue, Xia, Shiliang, Liu, Yang, Mao, Xueyu, Wu, Xuechun, Chu, Min, Niu, Huicong, Sun, Lulu, He, Yu, Liu, Yi, Guo, Daoxia, Shi, Mengyao, Zhang, Yonghong, Zhu, Zhengbao, Zhao, Jing
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomarkers; Biomarkers - blood; Brain natriuretic peptide; Clinical outcomes; Cohort analysis; Cohort Studies; Female; Follow-Up Studies; Heart; Humans; Ischemia; Ischemic Stroke - blood; Ischemic Stroke - diagnosis; L-Lactate dehydrogenase; L-Lactate Dehydrogenase - blood; Male; Medicine; Medicine & Public Health; Middle Aged; Natriuretic Peptide, Brain - blood; Neurology; Neuroradiology; Neurosciences; Original Communication; Peptide Fragments - blood; Plasma; Prognosis; Prospective Studies; Recovery of function; Risk factors; Stroke; Troponin; Troponin T; Troponin T - blood
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-024-12536-5

Background Impaired cardiac function was suggested to be implicated in the functional recovery after ischemic stroke, but the prognostic value of cardiac biomarkers among ischemic stroke patients remains unclear. We aimed to prospectively explore the associations of serum lactate dehydrogenase (LDH), plasma N-terminal pro-brain natriuretic peptide (NT-proBNP), and plasma high-sensitivity cardiac troponin T (hs-cTnT) with adverse clinical outcomes after ischemic stroke in a large-scale cohort study. Methods We measured serum LDH, plasma NT-proBNP, and plasma hs-cTnT levels at baseline among 5056 ischemic stroke patients from the Minhang Stroke Cohort study. All patients were followed up at 3 months after ischemic stroke onset. The primary outcome was composite outcome of death and major disability (modified Rankin Scale [mRS] score ≥ 3) at 3 months after stroke onset, and secondary outcomes included death and ordered 7-level categorical score of the mRS. Results During 3 months of follow-up, 1584 patients developed the primary outcome. Baseline serum LDH, plasma NT-proBNP, and plasma hs-cTnT were positively associated with the risk of adverse outcomes after ischemic stroke. The multivariable-adjusted odds ratios of primary outcome for the highest versus lowest quartile of LDH, NT-proBNP, and hs-cTnT were 1.37 (95% CI 1.13–1.66; P trend  = 0.001), 2.51 (95% CI, 2.00–3.16; P trend