High-sensitivity cardiac troponin T levels and risk of cerebral microbleeds in acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease
High-sensitivity cardiac troponin T levels and risk of cerebral microbleeds in acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease
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患有房颤和/或风湿性心脏病的急性缺血性卒中患者的高敏心肌肌钙蛋白 T 水平和脑微出血风险
DOI：
10.1016/j.jns.2016.08.003
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发表时间：
2016-10-15
影响因子：
4.4
通讯作者：
Liu, Ming
中科院分区：
文献类型：
--
作者：
Liu, Junfeng;Wang, Deren;Liu, Ming
背景和目的：高敏感性心肌肌钙蛋白T（hs-cTnT）水平升高通过与动脉粥样硬化相关而与冠状动脉疾病和小血管缺血性卒中相关。考虑到动脉粥样硬化和脑微出血（CMB）之间的关系，本研究的目的是探讨血清超敏cTnT水平和急性缺血性卒中患者CMB的风险之间的关联。方法：本前瞻性研究涉及连续招募急性缺血性卒中患者房颤和/或风湿性心脏病治疗在中国西南部的一个大型三级医院。收集临床人口统计学数据，并通过Logistic回归分析，以确定血清hscTnT水平和CMB发生和location.Results之间的关系：在最终的分析，66例患者（27名男性，平均年龄，68.7岁），39（59.1%）有CMB。Hs-cTnT水平与严格肺叶CMB的风险无关。然而，在调整了年龄、性别、当前饮酒量、总胆固醇、高血压、糖尿病、既往抗血栓治疗和入院时的NIHSS后，高三分位数的患者更有可能发生CMB和深部或幕下CMB（P < 0.05）。结论：Hs-cTnT可能是CMB发生的独立预测因子，尤其是深部或幕下CMB。这一发现证明了进一步研究hs-cTnT水平如何导致CMB和潜在的其他亚临床小血管疾病的合理性。(C)2016由Elsevier B. V.出版
Background and objective: Elevated high -sensitivity cardiac troponin T (hs-cTnT) levels are associated with coronary disease and small-vessel ischemic stroke through their associations with atherosclerosis. Considering the relationship between atherosclerosis and cerebral microbleeds (CMBs), the purpose of this study was to examine associations between serum hs-cTnT levels and risk of CMBs in acute ischemic stroke patients.Methods: This prospective study involved consecutively recruited acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease treated at a large tertiary care hospital in southwestern China. Clinico-demographic data were collected and analyzed by logistic regression to identify the relationship between serum hscTnT levels and CMB occurrence and location.Results: In the final analysis, of 66 patients (27 males; mean age, 68.7 years), 39 (59.1%) had CMBs. Hs-cTnT levels were not associated with risk of strictly lobar CMBs. However, after adjusting age, sex, current alcohol consumption, total cholesterol, hypertension, diabetes mellitus, prior antithrombotic therapy and NIHSS on admission, patients in the higher tertile were more likely to have CMBs and deep or infratentorial CMBs (P < 0.05) compared with the lower hs-cTnT tertile.Conclusion: Hs-cTnT may be an independent predictor for the occurrence of CMBs, particularly of deep or infratentorial CMBs. This finding justifies further research into how hs-cTnT levels may contribute to CMBs and potentially other subclinical small -vessel diseases. (C) 2016 Published by Elsevier B.V.