The Impact of Elevated Troponin Levels on Clinical Outcomes in Patients with Acute Ischemic Stroke: A Systematic Review

Abstract

The association between high cardiac troponin (cTn) levels and stroke characteristics and outcomes remains unclear. This systematic review aimed to determine the prevalence and clinical implications of elevated cTn levels in patients with acute ischemic stroke (AIS). We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, Science Direct, and Research Gate databases was conducted to identify relevant studies published in English up to May 2023. This study included all reports on serum cTn levels and AIS. Two independent reviewers assessed study quality and bias using study-specific tools before inclusion. The systematic review included a total of 14 articles with 16906 participants, including one systematic review, one randomized controlled trial (RCT), and 12 observational studies. The results of this systematic review indicate that the prevalence of high cTn levels is averaged at 17.9%, or 1 in 5 individuals, who have an AIS. The review emphasizes the detrimental effects of increased cTn levels on outcomes for in-hospital and all-cause mortality as well as cardiovascular outcomes in patients with AIS. These results demonstrate that serum cTn has the potential to be a useful tool for risk classification and prognostic assessment in individuals with AIS. AIS patients with elevated serum cTn at baseline have an increased risk of mortality. Early and routine evaluation of serum cTn may contribute to the timely detection of co-morbid cardiovascular injury and prevent unfavorable outcomes in patients with AIS.