BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Cardiac troponin (cTnI) is a marker of myocardial damage and may predict arrhythmia. We sought to determine if increased cTnI levels were a predictor of new-onset AF in ischemic stroke or patients with transient ischemic attack (TIA). METHODS: Consecutive patients who presented to Charles-Lemoyne Hospital between October 2006 and November 2010 with a diagnosis of acute ischemic stroke or TIA, without a history of AF, with a baseline measurement of cTnI were included in the study. The primary outcome was new-onset AF on 24-hour Holter measurement within 1 week of admission in patients without AF on the baseline electrocardiogram (ECG). Secondary outcomes included AF on Holter measurement, death, myocardial infarction (MI), and stroke within 3 months. RESULTS: A total of 408 patients were included. Forty-six patients (11.3%) had elevated cTnI levels. These patients were older and had a higher prevalence of coronary artery disease and diabetes. AF on baseline ECG or 24-hour Holter measurement was present in 51 patients (12.5%) and was more frequent among patients with increased cTnI levels compared to patients with normal cTnI levels (34.7% vs 9.7%; P = .004 multivariate analysis). Elevated cTnI levels also predicted the composite outcome of stroke, MI, and death at 3 months (50.0% vs 16.1%; P = .0001). CONCLUSIONS: cTnI elevation predicts new-onset AF on 24-hour Holter measurement in patients with acute ischemic stroke or TIA and may indicate a poorer prognosis and a higher risk of stroke, MI, and death at 3 months.
BACKGROUND:Atrial fibrillation (AF) is a major cause of ischemic stroke. Cardiac troponin (cTnI) is a marker of myocardial damage and may predict arrhythmia. We sought to determine if increased cTnI levels were a predictor of new-onset AF in ischemic stroke or patients with transient ischemic attack (TIA). METHODS: Consecutive patients who presented to Charles-Lemoyne Hospital between October 2006 and November 2010 with a diagnosis of acute ischemic stroke or TIA, without a history of AF, with a baseline measurement of cTnI were included in the study. The primary outcome was new-onset AF on 24-hour Holter measurement within 1 week of admission in patients without AF on the baseline electrocardiogram (ECG). Secondary outcomes included AF on Holter measurement, death, myocardial infarction (MI), and stroke within 3 months. RESULTS: A total of 408 patients were included. Forty-six patients (11.3%) had elevated cTnI levels. These patients were older and had a higher prevalence of coronary artery disease and diabetes. AF on baseline ECG or 24-hour Holter measurement was present in 51 patients (12.5%) and was more frequent among patients with increased cTnI levels compared to patients with normal cTnI levels (34.7% vs 9.7%; P = .004 multivariate analysis). Elevated cTnI levels also predicted the composite outcome of stroke, MI, and death at 3 months (50.0% vs 16.1%; P = .0001). CONCLUSIONS:cTnI elevation predicts new-onset AF on 24-hour Holter measurement in patients with acute ischemic stroke or TIA and may indicate a poorer prognosis and a higher risk of stroke, MI, and death at 3 months.
Authors: Barbara Ratajczak-Tretel; Anna Tancin Lambert; Henriette Johansen; Bente Halvorsen; Vigdis Bjerkeli; David Russell; Else Charlotte Sandset; Hege Ihle-Hansen; Erik Eriksen; Halvor Næss; Vojtech Novotny; Andrej Netland Khanevski; Thomas C Truelsen; Titto Idicula; Karen L Ægidius; Håkon Tobro; Siv B Krogseth; Håkon Ihle-Hansen; Guri Hagberg; Christina Kruuse; Kathrine Arntzen; Grete K Bakkejord; Maja Villseth; Ingvild Nakstad; Guttorm Eldøen; Raheel Shafiq; Anne Gulsvik; Martin Kurz; Mehdi Rezai; Jesper Sømark; Stein-Helge Tingvoll; Christine Jonassen; Susanne Ingebrigtsen; Linn Hofsøy Steffensen; Christine Kremer; Dan Atar; Anne Hege Aamodt Journal: Eur Stroke J Date: 2019-03-19
Authors: Charlotte Thalin; Bo Blomgren; Fariborz Mobarrez; Annika Lundstrom; Ann Charlotte Laska; Magnus von Arbin; Anders von Heijne; Elisabeth Rooth; Hakan Wallen; Sara Aspberg Journal: J Investig Med High Impact Case Rep Date: 2014-06-24
Authors: Michael D Hill; Renee H Martin; Yuko Y Palesch; Claudia S Moy; Diego Tamariz; Karla J Ryckborst; Elizabeth B Jones; David Weisman; Creed Pettigrew; Myron D Ginsberg Journal: PLoS One Date: 2015-09-01 Impact factor: 3.240