Abstract WP082: Prognostic Value of Cardiac Troponin I in Acute Ischemic Stroke Patients Treated with Thrombolytic Therapy.

Background: Cardiac troponin is a well-established diagnostic and prognostic marker in coronary heart disease. We investigated its prognostic value in acute ischemic stroke (AIS) patients treated with thrombolytic therapy. Methods: We conducted a retrospective observational study of AIS patients treated with thrombolytics at Southern Illinois Healthcare between 2017 and 2024. Demographics, clinical, laboratory, and radiographic data were collected. Outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and mRS at 30 days. Patients were divided by admission cardiac troponin I (cTnI) levels. Multivariable logistic regression was used to evaluate the association between cTnI and predetermined outcomes. Statistical significance was set at p<0.05. Results: Of 298 patients included in the study, 60 (20%) had elevated cTnI. Compared to patietns with normal cTnI, those with elevated levels were older (78 [68-87] vs. 67 [55-78] years), had higher rate of cardiac diseases (58% vs. 30%), and higher initial NIHSS (10 [6-18] vs. 6[4-11]). Elevated cTnI was associated with higher rate of sICH (8% vs. 1%, p=0.002), longer length of stay (5[3-8] vs. 3[2-5], p<0.001), higher rate of in-hospital mortality (17% vs. 4%, p<0.001), and lower rate of mRS ≤ 2 at 30 days (38% vs. 73%, p<0.001). After adjustment for age, preexistent cardiac disease, baseline mRS, and NIHSS, logistic regression revealed that elevated cTnI remained independently associated with development of sICH (OR: 11.817, 95%CI: 1.884-74.105, p=0.008) and lower odds of good short-term functional outcome (OR: 0.364, 95%CI: 0.174-0.758, p=0.007), but not with in-hospital mortality. Conclusions: In our population, elevation of cardiac enzymes at presentation was an independent factor associated with higher risk of sICH and worse short-term outcomes in AIS patients treated with thrombolytic therapy.