Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Serum Troponin Level Marker for Visceral Infarcts

J Stroke Cerebrovasc Dis; ePub 2019 Jan 18; Azher, et al

In ischemic stroke patients, elevated serum troponin levels may help identify patients with visceral infarcts, a recent study found. This suggests that troponin in the acute stroke setting is a biomarker of embolic risk. Data were abstracted from a single center prospective stroke database during 18 months and included all patients with ischemic stroke who underwent contrast-enhanced computerized tomography (CT) of the abdomen and pelvis for clinical purposes within 1 year of stroke. The primary predictor was troponin concentration ≥.1 ng/mL. The primary outcome was visceral infarct (renal and/or splenic) on CT abdomen and pelvis. Researchers found:

  • Of 1,233 patients with ischemic stroke, 259 patients had a qualifying visceral CT.
  • Serum troponin level on admission was measured in 237 of 259 patients (93.3%) and 41 of 237 (17.3%) had positive troponin.
  • There were 25 patients with visceral infarcts: 16 renal, 7 splenic, and 2 both.
  • In univariate models, patients with a positive troponin level (vs negative) were more likely to have visceral infarcts (39.1% [9/23] vs 15.0% [32/214]) and this association persisted in multivariable models.

Azher I, Kaushal A, Chang A, et al. Serum troponin level in acute ischemic stroke identifies patients with visceral infarcts. [Published online ahead of print January 18, 2019]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2019.01.004.