Role of troponin as a biomarker for predicting outcome after ischemic stroke

BACKGROUND: After acute ischemic stroke, a higher level of troponin has been considered as an important biomarker for predicting mortality. AIM AND OBJECTIVES: The study aimed to quantitatively assess the prognostic significance of the effect of baseline troponin levels on all-cause mortality in patients with acute ischemic stroke using a meta-analysis approach. MATERIALS AND METHODS: The following electronic databases such as PubMed, Web of Science, Cochrane Central Register of Controlled Trials, TRIP Database, and ClinicalTrialsgov were used for obtaining the relevant articles from literature. Data were extracted in standardized data collection form by two independent investigators. Any disagreements were resolved by consensus. All the statistical analyses were performed in STATA software (Version 13.1). RESULTS: A total of 19 studies were included in the present meta-analysis involving a total of 10,519 patients. The pooled analysis suggested that elevated serum troponin level was associated with inhospital mortality (rate ratios [RR] 2.34, 95% confidence interval [CI] 1.30–3.38) and at the end of last follow-up mortality (RR 2.01; 95% CI 1.62–2.40). Sensitivity analysis by removing a single study by turns indicated that there was no obvious impact of any individual study on the pooled risk estimate. No significant publication bias was observed in the beg test (P = 0.39); however, significant publication bias was observed in the egger test (P = 0.046). CONCLUSION: Our findings indicated that a higher level of troponin might be an important prognostic biomarker for all cause in hospital and follow-up mortalities in patients with acute ischemic stroke. These study findings offer insight into further investigation in prospective studies to validate this particular association. The study was registered in OSF registries DOI's 10.17605/OSF. IO/D95GN