Troponin levels help predict new-onset atrial fibrillation in ischaemic stroke patients: a retrospective study

Abstract

Background: Elevated levels of cardiac troponin I (cTnI) have been reported in acute stroke and atrial fibrillation (AF). We tested a hypothesis in which the result of an initial cTnI assay helps predict new-onset AF (NAF) early in the course of ischaemic stroke in patients with sinus rhythm on admission.

Methods: This retrospective study included all patients admitted to our unit for acute ischaemic stroke between January 2006 and December 2007 (n = 402). NAF was defined as AF discovered during cardiac monitoring in patients with sinus rhythm on admission. Elevated cTnI was defined as a value > or =0.03 microg/l.

Results: 27 (6.7%) patients had NAF. In a univariate analysis, age (70.8 in patients with NAF vs. 64.6 years in patients without NAF, respectively; p = 0.024), smoking status (3.5 vs. 25.3%; p = 0.009), total anterior circulation infarcts (18.5 vs. 5.9%; p = 0.03) and elevated cTnI levels (63.0 vs. 29.9%; p = 0.001) were associated with NAF. Stepwise logistic regression identified elevated cTnI levels (OR 4.1; 95% CI 1.81-9.33; p = 0.001)and active smoking (OR 0.11; 95% CI 0.01-0.82; p = 0.03) as independent factors for NAF.

Conclusion: Moderately elevated troponin levels in acute ischaemic stroke are independently associated with NAF.