Elevated high-sensitivity cardiac troponin T at admission was associated with increased odds of poor functional outcome by 141% (OR 2.41) and early mortality by 185% (OR 2.85) in acute intracerebral hemorrhage patients.
Cohort (n=256)
No
Does elevated admission high-sensitivity cardiac troponin T predict early mortality, overall mortality, and poor functional outcome in patients with acute intracerebral hemorrhage?
Admission elevated high-sensitivity cardiac troponin T is an independent predictor of early mortality and poor functional outcome at 90 days in patients with acute intracerebral hemorrhage.
Effect estimate: OR 2.41 for poor functional outcome, OR 2.85 for early mortality (95% CI 95% CI 1.06-5.49 for poor functional outcome, 95% CI 1.10-7.42 for early mortality)
Absolute Event Rate: 80.7% vs 53.6%
p-value: p=0.036 for poor functional outcome, 0.031 for early mortality
Abstract Background Intracerebral hemorrhage remains one of the most devastating forms of stroke, associated with high mortality and disability. Cardiac injury following ICH, mediated through the brain-heart axis, may serve as a marker of disease severity. High-sensitivity cardiac troponin T, which rises rapidly after myocardial injury, has potential prognostic value in stroke-heart syndrome. The objective of this study was to determine whether elevated high-sensitivity cardiac troponin T levels at hospital admission is associated with early mortality, overall mortality, and poor functional outcome at 90 days in patients with acute intracerebral hemorrhage. Methods This is a prospective cohort study, which enrolled 256 patients with acute ICH admitted within 24 h of onset to the Stroke Center, Bach Mai Hospital, from February 2025 to June 2025. Baseline characteristics, hematoma features, comorbidities, and high-sensitivity cardiac troponin T levels were collected immediately upon admission. Clinical outcomes included early mortality (< seven days), overall mortality, and poor functional outcome (modified Rankin Scale score 4–6) were evaluated. Multivariate regression identified independent associations. Results Elevated high-sensitivity cardiac troponin T levels was observed in 88 patients (34.4%). These patients had significantly lower Glasgow Coma Scale scores and larger hematoma volumes. Poor functional outcome occurred in 80.7% vs., 53.6% (p-value < 0.001), overall mortality in 65.9% vs., 33.9% (p-value < 0.001), and early mortality in 54.5% vs. 22.6% (p-value < 0.001) when comparing elevated and non-elevated high-sensitivity cardiac troponin T patients, respectively. After multivariable adjustment, elevated high-sensitivity cardiac troponin T (hs-cTnT) was independently associated with poor functional outcome (OR 2.41; 95% CI 1.06–5.49) and early mortality (OR 2.85; 95% CI 1.10–7.42). An association with overall mortality was also observed (OR 2.27; 95% CI 0.97–5.27), although this did not reach statistical significance. In time-to-event analyses, patients with elevated hs-cTnT experienced a significantly shorter restricted mean survival time compared with those without hs-cTnT elevation (13.9 vs. 22.4 days), corresponding to a mean survival difference of approximately 8.5 days (95% CI -11.2 to -5.8; p < 0.001). Conclusion Admission elevated high-sensitivity cardiac troponin T was associated with adverse outcomes in acute primary intracerebral hemorrhage and showed a notable association with early mortality.
Bui et al. (Wed,) conducted a cohort in acute primary intracerebral hemorrhage (n=256). elevated high-sensitivity cardiac troponin T vs. non-elevated high-sensitivity cardiac troponin T was evaluated on Poor functional outcome (mRS 4-6) and early mortality (<7 days) at 90 days (OR 2.41 for poor functional outcome, OR 2.85 for early mortality, 95% CI 95% CI 1.06-5.49 for poor functional outcome, 95% CI 1.10-7.42 for early mortality, p=0.036 for poor functional outcome, 0.031 for early mortality). Elevated high-sensitivity cardiac troponin T at admission was associated with increased odds of poor functional outcome by 141% (OR 2.41) and early mortality by 185% (OR 2.85) in acute intracerebral hemorrhage patients.