Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study

• Published in: BMJ 2000-06, Vol.320 (7248), p.1502-1504
• Main Authors: James, P, Ellis, C J, Whitlock, R M L, McNeil, A R, Henley, J, Anderson, N E
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Biological and medical sciences; Biomarkers - blood; Blood pressure; Cardiovascular disease; Chemicals; Confidence intervals; Consciousness; Creatine; Death; Female; Glucose; Health outcomes; Heart attacks; Heart diseases; Hospital admissions; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Mortality; Multivariate analysis; Myocardial ischemia; Nervous system; New Zealand - epidemiology; Observational studies; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Patients; Stroke; Stroke - blood; Stroke - mortality; Strokes; Studies; Survival Analysis; Tissue grafting; Tomography; Troponin T - blood
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.320.7248.1502

Abstract Objective: To assess whether a raised serum troponin T concentration would be an independent predictor of death in patients with an acute ischaemic stroke. Design: Observational study. Setting: Auckland Hospital, Auckland, New Zealand. Subjects: All 181 patients with an acute ischaemic stroke admitted over nine months in 1997-8, from a total of 8057 patients admitted to the acute medical service. Main outcome measures: Blood samples for measuring troponin T concentration were collected 12-72 hours after admission; other variables previously associated with severity of stroke were also recorded and assessed as independent predictors of inpatient mortality. Results: Troponin T concentration was raised (>0.1 μg/l) in 17% (30) of patients admitted with an acute ischaemic stroke. Thirty one patients died in hospital (12/30 (40%) patients with a raised troponin T concentration v 19/151 (13%) patients with a normal concentration (relative risk 3.2 (95% confidence 1.7 to 5.8; P=0.0025)). Of 17 possible predictors of death, assessed in a multivariate stepwise model, only a raised troponin T concentration (P=0.0002), age (P=0.0008), and an altered level of consciousness at presentation (P=0.0074) independently predicted an adverse outcome. Conclusions: Serum troponin T concentration at hospital admission is a powerful predictor of mortality in patients admitted with an acute ischaemic stroke.