- 作者：Isabelle Beaulieu-Boire ; Nancy Leblanc ; L¨¦o Berger ; Jean-Martin Boulanger
- 关键词：Acute stroke ; atrial fibrillation ; cardiac emboli ; cerebrovascular accident ; transient ischemic attack
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：22
- 期：7
- 页码：978-983
- 全文大小：79 K
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.