Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke

Csécsei, Péter; Pusch, Gabriella; Ezer, Erzsébet; Berki, Tímea; Szekeres, L.; Illés, Zsolt; Molnár, Tihamér

doi:10.1016/j.jstrokecerebrovasdis.2017.10.040

Cited by 15 publications

(12 citation statements)

References 30 publications

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“…Cardiac participation in the secondary increase of S100B should be questioned. In this study there was no significant difference in troponin levels between the two groups at admission, despite known positive correlation between the two proteins [14]. However, troponin during hospitalization was not monitored.…”

Section: Discussioncontrasting

confidence: 59%

Secondary S100B Protein Increase Following Brain Arteriovenous Malformation Rupture is Associated with Cerebral Infarction

et al. 2020

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Early S100B protein serum elevation is associated with poor prognosis in patients with ruptured brain arteriovenous malformations (BAVM). The purpose of this study is to determine whether a secondary elevation of S100B is associated with early complications or poor outcome in this population. This is a retrospective study of patients admitted for BAVM rupture. A secondary increase of S100B was defined as an absolute increase by 0.1 μg/L within 30 days of admission. Fisher’s and unpaired t tests followed by multivariate analysis were performed to identify markers associated with this increase. Two hundred and twenty-one ruptures met inclusion criteria. Secondary S100B protein serum elevation was found in 17.1% of ruptures and was associated with secondary infarction (p < 0.001), vasospasm-related infarction (p < 0.001), intensive care (p = 0.009), and hospital length of stay (p = 0.005), but not with early rebleeding (p = 0.07) or in-hospital mortality (p = 0.99). Secondary infarction was the only independent predictor of secondary increase of S100B (OR 9.9; 95% CI (3–35); p < 0.001). Secondary elevation of S100B protein serum levels is associated with secondary infarction in ruptured brain arteriovenous malformations.

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Section: Discussioncontrasting

confidence: 59%

Secondary S100B Protein Increase Following Brain Arteriovenous Malformation Rupture is Associated with Cerebral Infarction

et al. 2020

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“…Activation of neutrophils reflected by NAR was shown here as the most sensitive marker of recurrence of ischemic cerebral episodes in post-stroke patients taking clopidogrel. Both, animal and clinical data support the pivotal role of activated peripheral blood cells (e.g., neutrophils, monocytes, platelets) in neuroinflammation due to ischemic stroke (2,3,11). One side, the dynamic microcirculatory stall phenomenon in the hyperacute stage can be a contributing factor to ongoing penumbral brain injury (2,12), on the other side the sustained detrimental effects of activated leukocytes in the systemic circulation carries a constant risk in patients with chronic inflammatory state (e.g., vascular diseases) (13).…”

Section: Discussionmentioning

confidence: 91%

Novel Predictors of Future Vascular Events in Post-stroke Patients—A Pilot Study

et al. 2021

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Introduction: A modified platelet function test (mPFT) was recently found to be superior compared to impedance aggregometry for selection of post-stroke patients with high on-treatment platelet reactivity (HTPR). We aimed to explore some peripheral blood cell characteristics as predictors of recurrent ischemic episodes. The predictive value of mPFT was also assessed in a cohort followed up to 36 months regarding recurrent ischemic vascular events.Methods: As a novelty, not only whole blood (WB), but after 1-h gravity sedimentation the separated upper (UB) and lower half blood (LB) samples were analyzed including neutrophil antisedimentation rate (NAR) in 52 post-stroke patients taking clopidogrel. Area under the curve (AUC, AUCupper and AUClower, respectively) was separately measured by Multiplate in the WB, UB and LB samples to characterize ex vivo platelet aggregation in the presence of ADP. Next, the occurrence of vascular events (stroke, acute coronary syndrome, ACS) were evaluated during 36-month follow-up.Results: A total of 11 vascular events (stroke n = 5, ACS n = 6) occurred during the follow-up period. The AUCupper was significantly higher in patients with recurrent stroke compared to those with uneventful follow-up (p = 0.03). The AUCupper with a cut-off value ≥70 based on the mPFT, was able to predict all stroke events (p = 0.01), while the total vascular events were independently predicted by NAR with a sensitivity of 82% and specificity of 88%.Conclusions: A combination of NAR reflecting the inflammatory state and AUCupper indicating HTPR may provide a better prediction of recurrent ischemic events suggesting a better selection of patients at risk, thus providing an individually tailored vascular therapy.

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“…Thus, occult or subclinical myocardial disease could be implicated as a cause of death in acute respiratory distress syndrome. Other areas, where elevated troponin values have been demonstrated to be predictive of in-hospital mortality have included ischaemic stroke [50] , intra-cerebral haemorrhage [51] , gastro-intestinal haemorrhage [52] , non-cardiac surgery [53] , renal failure [54] , and following renal transplant [55] .…”

Section: Discussionmentioning

confidence: 99%

Troponin status predicts 30-day in-hospital mortality

Conway¹,

Byrne²,

Cournane³

et al. 2020

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Aim: To evaluate the prognostic value of high-sensitivity cardiac troponin (hscTnT) levels in unselected emergency medical admissions. Methods: We report on all hscTnT tests in emergency medical admissions, performed over an eight year period from 2011-2018. The prognostic significance of hscTnT was related to 30-day in-hospital mortality with multivariable logistic regression, adjusted for Acute Illness Severity Score, Comorbidity Score, Sepsis, and Deprivation Status. Results: There were 52,214 admissions from 28,982 patients during the study period. HscTnT level was a univariate-odds ratios (OR) 1.67 [95% confidence intervals (CI): 1.60-1.73] and an independent risk predictor in the multivariable logistic regression model-OR = 1.23 (95%CI: 1.16-1.29). 30-day in-hospital mortality increased as a linear function of hscTnT; not performed = 3.6%, ≥ 25 ng/L = 5.3%, > 100 ng/L = 7.4%, > 1000 ng/L = 8.8%. Increasing Comorbidity Score exacerbated risk; 30-day in-hospital mortality at a Score of 6, 10 and 16 points for those with no hscTnT performed or hscTnT < 25 ng/L were 1.8%, 6.5% and 31.3% respectively; for hscTnT ≥ 25 ng/L these increased to 2.2%, 8.8% and 41.3%. Conclusion: HscTnT is prognostic in acutely ill medical patients; incorporation into hospital mortality predictive algorithms appears warranted.

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Relationship between Cardiac Troponin and Thrombo-Inflammatory Molecules in Prediction of Outcome after Acute Ischemic Stroke

Cited by 15 publications

References 30 publications

Secondary S100B Protein Increase Following Brain Arteriovenous Malformation Rupture is Associated with Cerebral Infarction

Secondary S100B Protein Increase Following Brain Arteriovenous Malformation Rupture is Associated with Cerebral Infarction

Novel Predictors of Future Vascular Events in Post-stroke Patients—A Pilot Study

Troponin status predicts 30-day in-hospital mortality

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