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J Neurol. 2019 Jan;266(1):37-45. doi: 10.1007/s00415-018-9085-3. Epub 2018 Oct 11.

High-sensitivity cardiac troponin T and severity of cerebral white matter lesions in patients with acute ischemic stroke.

Author information

1
Klinik für Neurologie, Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany. regina-irene.freiin-von-rennenberg@charite.de.
2
Center for Stroke Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
3
Klinik für Neurologie, Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité-Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
4
Berlin-Brandenburg Center for Regenerative Therapies, Charite Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
5
Medizinische Klinik mit Schwerpunkt Kardiologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
6
German Center for Cardiovascular Research (Deutsches Zentrum für Herz-Kreislaufforschung), Partner Site Berlin, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
7
German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen), Partner Site Berlin, Charitéplatz 1, 10117, Berlin, Germany.
8
Berlin Institute of Health, Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.

Abstract

INTRODUCTION:

Cardiac troponin (hs-cTnT) is a sensitive marker of myocardial injury and has been linked to incident dementia. The underlying mechanism of that observation is still unknown. Given that severity of cerebral small vessel disease is a predictor of cognitive decline, we aimed to explore whether there is an association between hs-cTnT and severity of white matter lesions (WML) as a marker of cerebral small vessel disease in patients with ischemic stroke.

METHODS:

We analyzed consecutive acute ischemic stroke patients admitted to Charité-University Hospital, Berlin from 2011 to 2013. Severity of WML was graded on 3T-MRI using the age-related white matter severity score (ARWMS). Patients with hs-cTnT elevation suggestive of acute coronary syndrome (ACS) were excluded (hs-cTnT > 52 ng/l or dynamic change of hs-cTnT > 50%, ESC guideline). We performed unadjusted and adjusted quantile regression models to assess the association between increased hs-cTnT (dichotomized at the 99th percentile, 14 ng/l) and severity of WML.

RESULTS:

A total of 860 patients was analyzed (median age 73 years, 44.8% female, median ARWMS 6). Patients with elevated hs-cTnT had more extensive WML than those without (median ARWMS 8 vs. 5, adjusted beta for 50th percentile 1.12, 95% CI 0.41-1.84). The association between WML and hs-cTnT elevation was strongest in patients with severe WML (adjusted beta 1.77, 95% CI 0.26-3.27 for 80th WML percentile).

CONCLUSION:

Elevated hs-cTnT levels were associated with extent of WML in acute stroke patients. Further studies are needed to assess whether hs-cTnT can be used to identify stroke patients at risk for cognitive decline.

KEYWORDS:

Cardiac troponin; Cerebral white matter lesions; Cognitive impairment; Stroke

PMID:
30311052
DOI:
10.1007/s00415-018-9085-3

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