Elevated troponin levels are associated with early neurological worsening in ischemic stroke with atrial fibrillation

Serum cardiac troponin I (cTnI) is often elevated in patients with ischemic stroke, and is associated with their prognosis. Since cTnI is also closely related to atrial fibrillation (AF), cTnI may be a sensitive prognostic indicator in patients with AF-related stroke. This study aimed to evaluate the association between serum cTnI and early neurological deterioration (END) in patients with AF-related stroke. We included consecutive AF-related stroke patients between 2013 and 2015. END was defined as an increase >= 2 in the total NIHSS score or >= 1 in the motor NIHSS score within the first 72 h of admission. A total of 1,133 patients with AF-related stroke were evaluated. In multivariable analysis, cTnI [adjusted odds ratio (aOR)=1.16, 95% confidence interval (CI) 1.00-1.34; P=0.047] remained significant after adjusting for confounders. Initial NIHSS score (aOR=1.03, 95% CI 1.00-1.06; P=0.043) was also positively associated with END; meanwhile, the use of anticoagulants was negatively associated in both vitamin K antagonists (aOR=0.35, 95% CI 0.23-0.54; P<0.001) and new oral anticoagulants (aOR=0.41, 95% CI 0.19-0.89; P=0.024). In conclusion, higher serum cTnI was associated with END in patients with AF-related stroke.