ABSTRACT NUMBER: ESOC2026A460 PLASMA PROTEOMIC PROFILES LINKED TO POST-STROKE MYOCARDIAL INJURY

Abstract Background and aims Acute myocardial injury after stroke is considered part of the spectrum of the stroke-heart syndrome and is strongly associated with unfavorable short-term outcomes. The aim of this study was to identify plasma proteomic changes among stroke patients with acute myocardial injury compared to those without. Methods Two OLINK® target 96 panels (inflammation, cardiovascular II) were measured in EDTA plasma samples of patients with imaging-confirmed acute ischemic stroke as part of the prospective, observational CORONA-IS study (NCT03892226,01/2019-12/2023). Patients were categorized according to presence and absence of acute myocardial injury (defined as high-sensitivity cardiac troponinT[hs-cTnT]>upper reference limit with a rise/fall >20% in repeated measurements). Results Blood samples were obtained within a median of 59 [42-73] hours after symptom onset. A total of 160 proteins from 100 patients with acute myocardial injury (median age 78 [69-82] years, 42% female, peak hs-cTnT 37ng/l [24-106]) and 100 patients without myocardial injury (median age 73 [66-79] years, 46% female, peak hs-cTnT 10ng/l [7-12]) were analyzed. We observed 46.3% differentially expressed proteins in patients with acute myocardial injury. IL-6, CTSL1, TRAIL-R2, TNFRSF10A, TNFRSF11A, ADM, TGF-alpha, VSIG2, and IL4-RA showed the strongest positive protein associations. Protein-Protein network interaction and gene ontology analysis revealed proteins involved in neutrophil chemotaxis, monocyte chemotaxis and cytokine activity to be linked to acute myocardial injury. Conclusions Our findings support the hypothesis that acute myocardial injury after stroke is accompanied by a systemic pro-inflammatory response. These data provide insights for potential mechanisms that can be targeted in interventional studies. Conflict of interest All: Nothing to disclose