Troponin T elevation in acute intracranial hemorrhage

Introduction Troponin T elevation is associated with increased stroke severity and mortality, and with worsened clinical outcomes. However, most studies have involved acute ischemic stroke patients. 
We aimed to evaluate high-sensitivity troponin T elevation frequency in our cohort of acute intracerebral hemorrhage (ICH) patients, to identify clinical, radiological and biological factors associated with troponin increase, and to study its prognostic impact.

Methods Consecutive patients admitted to our tertiary care academic stroke center from January 2012 to December 2016 for radiologically-confirmed ICH <24 hours of symptom onset were included. Clinical, radiological, EKG and biological variables were collected, including high-sensitivity troponin T levels. Patients with secondary ICH, severe renal insufficiency, or recent ( <14 days) acute coronary syndrome, ischemic stroke or cerebral catheter angiography were excluded. 

Results Of the 232 included patients (mean age 74.9±12 years, 58.6% men), 50% had high (>14ng/L) troponin T levels. Older age, male sex, higher admission glycaemia, previous ischemic stroke or TIA, mild-to-moderate renal insufficiency and EKG anomalies were independently associated with troponin elevation at multivariate analysis. Six-month mortality rate was 32%. Acute phase troponin T increase was not associated with poor clinical outcome (mRS >2).

Conclusion Troponin T elevation occurred in half our acute ICH patients. Older age, male sex, higher admission glycaemia, previous ischemic stroke or TIA, mild-to-moderate renal insufficiency and EKG anomalies were independently associated with troponin elevation, which was not associated with poor clinical outcome.

TROPONIN T ELEVATION IN ACUTE INTRACRANIAL HEMORRHAGE