ABSTRACT NUMBER: ESOC2026A2032 THE SIGNIFICANCE OF HIGH-SENSITIVE TROPONIN T IN PATIENTS WITH TRANSIENT ISCHEMIC ATTACKS

Abstract Background and aims High-sensitivity troponin T (hs-cTnT) is frequently elevated after transient ischemic attacks (TIAs). Yet, unlike in acute ischemic stroke (AIS), its prognostic value remains underexplored. This study aimed to evaluate associations between admission hs-cTnT levels in patients with TIA and clinical outcome events. Methods Consecutive TIA patients treated at our tertiary stroke center (2015-2019) were included. Hs-cTnT levels were measured on admission as part of routine clinical care. Patients were grouped based on whether hs-cTnT levels were within the normal range or elevated. The primary outcome was recurrent AIS. Secondary outcomes included major adverse cardiovascular events (MACE; composite of cardiovascular death, myocardial infarction, and AIS) and all-cause mortality during long-term follow-up. Associations between hs-cTnT and outcomes were assessed using Cox proportional hazards models with multivariable adjustment. Predefined subgroup analyses were performed restricted to patients with hs-cTnT levels ≥5-fold above the upper reference limit. Results n = 1478 patients were included (47% female, median age 72 years, 6% with recurrent AIS). In multivariable analysis, elevated hs-cTnT was independently associated with recurrent AIS (adjusted HR [aHR] 1.73, 95% CI 1.01–2.98), MACE (aHR 1.52, 95% CI 1.07–2.16), and all-cause mortality (aHR 4.68, 95% CI 3.30–6.63). In patients with ≥5-fold elevated hs-cTnT, there was an independent association with MACE and all-cause mortality, but not in recurrent AIS. Conclusions Elevated hs-cTnT after TIA seems to be associated with recurrent AIS, MACE, and long-term mortality. These findings underscore the potential role of hs-cTnT for risk stratification and support intensified diagnostic and secondary prevention strategies. Conflict of interest Regarding the scope of this abstract, the authors have nothing to disclose.