Early Elevated Troponin Levels after Ischemic Stroke Suggests a Cardioembolic Source (P4.031)

Objective: To investigate whether early elevated troponin levels following ischemic stroke can be used as a marker of embolic stroke subtypes (cardioembolic [CE] and embolic stroke of unknown source [ESUS]) as opposed to non-cardioembolic subtypes (large vessel disease, small vessel disease, and other). Background: Elevated cardiac troponin is a marker of cardiac disease and has recently been shown to be associated with embolic stroke risk. Design/Methods: We abstracted data from our prospective ischemic stroke database and included all patients with ischemic stroke over a 22-month period. Per our laboratory, we defined positive troponin as ≥ 0.1 ng/mL and intermediate as ≥ 0.06 ng/mL and negative as Results: We identified 1234 patients, of whom 1129 had admission troponin levels available; 10.0% (113/1129) had a positive troponin. In fully adjusted models,, there was an association between troponin positivity and ESUS subtype (adjusted odds ratio [OR] 4.46, 95% confidence interval [CI] 1.03–7.97, p=0.003) and CE stroke subtype (OR 5.00; 95% CI 1.83–13.63; p=0.002). There was no association between intermediate troponin levels and either ESUS or CE stroke subtypes. Conclusions: We found that early positive troponin after ischemic stroke may be independently associated with a cardiac embolic source. Future studies are needed to confirm our findings using high sensitivity troponin assays and to test optimal secondary prevention strategies in patients with ESUS and positive troponin. Disclosure: Dr. Chang has nothing to disclose. Dr. Ricci has nothing to disclose. Dr. Russo has nothing to disclose. Dr. Jayaraman has nothing to disclose. Dr. McTaggart has nothing to disclose. Dr. Hemendinger has nothing to disclose. Dr. Narwal has nothing to disclose. Dr. Dakay has nothing to disclose. Dr. Mac Grory has nothing to disclose. Dr. Cutting has nothing to disclose. Dr. Burton has nothing to disclose. Dr. Song has nothing to disclose. Dr. Mehanna has nothing to disclose. Dr. Siket has nothing to disclose. Dr. Madsen has nothing to disclose. Dr. Reznik has nothing to disclose. Dr. Merkler has nothing to disclose. Dr. Lerario has nothing to disclose. Dr. Kamel has nothing to disclose. Dr. Elkind has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abbott, Boehringer-Ingelheim, Merck/Organon, Hi-Tech Pharmaceuticals, and Auxilium. . Dr. Furie has nothing to disclose. Dr. Yaghi has nothing to disclose.