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논문 기본 정보

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저자정보
Sung-Ho Ahn (Department of Neurology Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Pusan National University School of Medicine Busan Korea) Ji-Sung Lee (Clinical Research Center Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Mi-Sook Yun (Division of Biostatistics Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Pusan National University School of Medicine Busan Korea) Jung-Hee Han (Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Soo-Young Kim (Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Young-Hak Kim (Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Sang-Hyun Lee (Division of Cardiology Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Pusan National University School of Medicine Busan Korea) Min-Gyu Park (Department of Neurology Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Pusan National University School of Medicine Busan Korea) Kyung-Pil Park (Department of Neurology Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Pusan National University School of Medicine Busan Kor) Dong-Wha Kang (Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul Korea) Jong S. Kim (Department of Neurology Gangneung Asan Hospital University of Ulsan Gangneung Korea) Sun U. Kwon (Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul Korea)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제25권 제1호
발행연도
2023.1
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141 - 150 (10page)

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Background and Purpose We investigated the impact of comorbidity burden on troponin elevation, with separate consideration of neurological conditions, in patients with acute ischemic stroke (AIS). Methods This prospective, observational cohort study consecutively enrolled patients with AIS for 2 years. Serum cardiac troponin I was repeatedly measured, and disease-related biomarkers were collected for diagnosis of preassigned comorbidities, including atrial fibrillation (AF), ischemic heart disease (IHD), myocardial hypertrophy (MH), heart failure (HF), renal insufficiency (RI), and active cancer. The severity of neurological deficits and insular cortical ischemic lesions were assessed as neurological conditions. Adjusted associations between these factors and troponin elevation were determined using a multivariate ordinal logistic regression model and area under the receiver operating characteristic curve (AUC). Cox proportional hazards model was used to determine the prognostic significance of comorbidity beyond neurological conditions. Results Among 1,092 patients (66.5±12.4 years, 63.3% male), 145 (13.3%) and 335 (30.7%) had elevated (≥0.040 ng/mL) and minimally-elevated (0.040–0.010 ng/mL) troponin, respectively. In the adjusted analysis, AF, MH, HF, RI, active cancer, and neurological deficits were associated with troponin elevation. The multivariate model with six comorbidities and two neurological conditions exhibited an AUC of 0.729 (95% confidence interval [CI], 0.698–0.759). In Cox regression, AF, IHD, and HF were associated with adverse cardio-cerebrovascular events, whereas HF and active cancer were associated with mortality. Conclusion Troponin elevation in patients with AIS can be explained by the burden of comorbidities in combination with neurological status, which explains the prognostic significance of troponin assay.
#Troponin #Stroke #Comorbidity #Prognosis

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