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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Troponin T Predicts Cardioembolic Aetiology and Clinical Outcome in Undetermined Ischaemic Stroke in Hyperacute Phase
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Troponin T Predicts Cardioembolic Aetiology and Clinical Outcome in Undetermined Ischaemic Stroke in Hyperacute Phase

机译：肌钙蛋白T预测超急性期缺血性卒中的心脏病释放性和临床结果

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Background: Elevated high-sensitivity cardiac troponin T (hs-cTnT) levels have been related to clinical outcome in stroke patients. However, the role of hs-cTnT and its potential as a biomarker in ischaemic stroke (IS) has not been well established. This study aims to determine whether basal hs-cTnT determination in the hyperacute phase of undetermined IS and transient ischaemic attack (TIA) can predict the cardioembolic aetiology and clinical outcome. Methods: We prospectively studied 110 consecutive patients with undetermined acute IS and TIA. hs-cTnT levels were determined at hospital arrival. Large vessel stenosis/occlusion and previously known aetiologies at admission were exclusion criteria for this study. All patients were subjected to a complete aetiological evaluation. A 12-month follow-up was performed in all patients. The subtype of IS was evaluated following the SSS-TOAST criteria. We established two groups at admission: cardioembolic aetiology (group A) and noncardioembolic aetiologies (group B). Results: The number of patients in each group was similar (group A: 52, 47.27%; group B, 58, 52.73%). Patients in group A had elevated hs-cTnT more frequently (61.54% versus 17.24%; P < .001). Group A patients had significantly higher mortality at 3 months (14.29% versus 1.82%, P = .025). In the multivariate analysis, elevated hs-cTnT was the only independent predictor of cardioembolic aetiology (odds ratio: 14.821; 95% confidence interval: 3.717-59.102, P < .001). Conclusion: Baseline hs-cTnT assessment in undetermined strokes and TIA during the hyperacute phase is independently associated with cardioembolic aetiology.
机译：背景：高敏心肌肌钙蛋白T（hs-cTnT）水平升高与脑卒中患者的临床预后有关。然而，hs-cTnT在缺血性卒中（IS）中的作用及其作为生物标志物的潜力尚未完全确定。本研究旨在确定在未定IS和短暂性脑缺血发作（TIA）的超急性期基础hs-cTnT测定是否能预测心肌栓塞的病因和临床结果。方法：我们前瞻性研究了110例不确定的急性IS和TIA患者。hs-cTnT水平在抵达医院时测定。大血管狭窄/闭塞和入院时已知的病因是本研究的排除标准。所有患者均接受完整的病因学评估。对所有患者进行了12个月的随访。IS亚型的评估遵循SSS-TOAST标准。我们在入院时分为两组：心源性栓塞病因组（A组）和非心源性栓塞病因组（B组）。结果：各组患者数量相似（A组52例，占47.27%；B组58例，占52.73%）。A组患者hs-cTnT升高的频率更高（61.54%对17.24%；P<0.001）。A组患者在3个月时的死亡率显著较高（14.29%对1.82%，P=0.025）。在多变量分析中，hs-cTnT升高是心脏栓塞病因的唯一独立预测因子（优势比：14.821；95%可信区间：3.717-59.102，P<0.001）。结论：在超急性期对未确定的中风和短暂性脑缺血发作（TIA）进行基线hs-cTnT评估与心肌栓塞病因独立相关。

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