Predictive ability of cardiac biomarkers for early risk stratification and 3-month functional outcomes after reperfusion therapy in acute ischemic stroke
Neurological Research, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/01616412.2026.2694662
- Dergi Adı: Neurological Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Acute ischemic stroke, cardiac biomarkers, reperfusion therapy, prognosis, high-sensitivity cardiac troponin
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study aimed to determine the prognostic value of baseline serum cardiac biomarkers measured at emergency department admission in patients with acute ischemic stroke undergoing reperfusion therapy. Method: This retrospective cohort study evaluated data from 433 AIS patients treated with intravenous thrombolysis (IVT), mechanical thrombectomy (MT), or combined therapy. Serum lactate dehydrogenase, creatine kinase, plasma N-terminal pro-brain natriuretic peptide, and high-sensitivity cardiac troponin T levels were analyzed. Stroke severity, functional outcomes, hemorrhagic transformation, and mortality were assessed. Continuous variables were evaluated using the Shapiro-Wilk test, Kruskal-Wallis ANOVA, and post-hoc pairwise comparisons. Diagnostic efficacy was calculated using ROC-AUC and the Youden Index. Independent risk factors were identified via Multivariate Logistic Regression analysis. Results: High-sensitivity cTnT predicted functional prognosis at both discharge and 3 months, whereas LDH predicted outcomes exclusively at 3 months. Elevated CK and LDH levels correlated significantly with stroke etiology. An hs-cTnT value > 10.5 pg/mL independently increased the risk of poor discharge prognosis (OR: 1.725, p < 0.05). In multivariate logistic regression, age, baseline NIHSS, and hs-cTnT were independent risk factors for poor discharge outcomes. For 3-month mRS scores, the optimal prognostic cut-off values were > 200 U/L for LDH (p = 0.003) and >10.5 pg/mL for hs-cTnT (p = 0.007). In the final multivariate model, baseline NIHSS, stroke etiology, LDH (>200 U/L, OR: 1.845, p < 0.05), and hs-cTnT (>10.5 pg/mL, OR: 1.685, p < 0.05) emerged as independent risk factors for a poor 3-month prognosis. Conclusion: Integrating admission cardiac biomarkers into clinical evaluation scores significantly enhances risk stratification and predictive accuracy in acute ischemic stroke management.