Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study

Objective To assess whether a raised serum troponin T concentration would b e an independent predictor of death in patients with an acute ischaemic str oke. Design Observational study. Setting Auckland Hospital, Auckland, New Zealand. Subjects All 181 patients with an acute ischaemic stroke admitted over nine months in 1997-8, from a total of 8057 patients admitted to the acute medi cal service. Main outcome measures Blood samples for measuring troponin T concentration were collected 12-72 hours after admission; other variables previously asso ciated with severity of stroke were also recorded and assessed as independe nt predictors of inpatient mortality: Results Troponin T concentration was raised(>0.1 mu g/l) in 17% (30) of pat ients admitted with an acute ischaemic stroke. Thirty one patients died in hospital (12/30 (40%,) patients with a raised troponin T concentration v 19 /151 (13%) patients with a normal concentration (relative risk 3.2 (95% con fidence 1.7 to 5.8: p = 0.0025)). Of 17 possible predictors of death, asses sed in a multivariate stepwise model, only a raised troponin T concentratio n (P = 0.0002), age (P = 0.0008), and an altered let:ei of consciousness at presentation (P = 0.0074) independently predicted an adverse outcome. Conclusions Serum troponin T concentration at hospital admission is a power ful predictor of mortality in patients admitted with an acute ischaemic str oke.