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Background <p>Intracerebral hemorrhage remains one of the most devastating forms of stroke, associated with high mortality and disability. Cardiac injury following ICH, mediated through the brain-heart axis, may serve as a marker of disease severity. High-sensitivity cardiac troponin T, which rises rapidly after myocardial injury, has potential prognostic value in stroke-heart syndrome. The objective of this study was to determine whether elevated high-sensitivity cardiac troponin T levels at hospital admission is associated with early mortality, overall mortality, and poor functional outcome at 90 days in patients with acute intracerebral hemorrhage.</p> Methods <p>This is a prospective cohort study, which enrolled 256 patients with acute ICH admitted within 24&#xa0;h of onset to the Stroke Center, Bach Mai Hospital, from February 2025 to June 2025. Baseline characteristics, hematoma features, comorbidities, and high-sensitivity cardiac troponin T levels were collected immediately upon admission. Clinical outcomes included early mortality (&lt; seven days), overall mortality, and poor functional outcome (modified Rankin Scale score 4–6) were evaluated. Multivariate regression identified independent associations.</p> Results <p>Elevated high-sensitivity cardiac troponin T levels was observed in 88 patients (34.4%). These patients had significantly lower Glasgow Coma Scale scores and larger hematoma volumes. Poor functional outcome occurred in 80.7% vs., 53.6% (p-value &lt; 0.001), overall mortality in 65.9% vs., 33.9% (p-value &lt; 0.001), and early mortality in 54.5% vs. 22.6% (p-value &lt; 0.001) when comparing elevated and non-elevated high-sensitivity cardiac troponin T patients, respectively. After multivariable adjustment, elevated high-sensitivity cardiac troponin T (hs-cTnT) was independently associated with poor functional outcome (OR 2.41; 95% CI 1.06–5.49) and early mortality (OR 2.85; 95% CI 1.10–7.42). An association with overall mortality was also observed (OR 2.27; 95% CI 0.97–5.27), although this did not reach statistical significance. In time-to-event analyses, patients with elevated hs-cTnT experienced a significantly shorter restricted mean survival time compared with those without hs-cTnT elevation (13.9 vs. 22.4 days), corresponding to a mean survival difference of approximately 8.5 days (95% CI -11.2 to -5.8; <i>p</i> &lt; 0.001).</p> Conclusion <p>Admission elevated high-sensitivity cardiac troponin T was associated with adverse outcomes in acute primary intracerebral hemorrhage and showed a notable association with early mortality.</p>

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Association between admission high-sensitivity cardiac troponin T levels and clinical outcomes in acute intracerebral hemorrhage: a prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月25日

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  • Quoc Viet Bui,
  • Anh Tuan Nguyen,
  • Viet Hai Nguyen,
  • Tien Dung Nguyen,
  • Xuan Trung Vuong,
  • Hong Son Trinh,
  • Van Hung Nguyen,
  • Minh Thu Vu,
  • Viet Phuong Dao

摘要

Background

Intracerebral hemorrhage remains one of the most devastating forms of stroke, associated with high mortality and disability. Cardiac injury following ICH, mediated through the brain-heart axis, may serve as a marker of disease severity. High-sensitivity cardiac troponin T, which rises rapidly after myocardial injury, has potential prognostic value in stroke-heart syndrome. The objective of this study was to determine whether elevated high-sensitivity cardiac troponin T levels at hospital admission is associated with early mortality, overall mortality, and poor functional outcome at 90 days in patients with acute intracerebral hemorrhage.

Methods

This is a prospective cohort study, which enrolled 256 patients with acute ICH admitted within 24 h of onset to the Stroke Center, Bach Mai Hospital, from February 2025 to June 2025. Baseline characteristics, hematoma features, comorbidities, and high-sensitivity cardiac troponin T levels were collected immediately upon admission. Clinical outcomes included early mortality (< seven days), overall mortality, and poor functional outcome (modified Rankin Scale score 4–6) were evaluated. Multivariate regression identified independent associations.

Results

Elevated high-sensitivity cardiac troponin T levels was observed in 88 patients (34.4%). These patients had significantly lower Glasgow Coma Scale scores and larger hematoma volumes. Poor functional outcome occurred in 80.7% vs., 53.6% (p-value < 0.001), overall mortality in 65.9% vs., 33.9% (p-value < 0.001), and early mortality in 54.5% vs. 22.6% (p-value < 0.001) when comparing elevated and non-elevated high-sensitivity cardiac troponin T patients, respectively. After multivariable adjustment, elevated high-sensitivity cardiac troponin T (hs-cTnT) was independently associated with poor functional outcome (OR 2.41; 95% CI 1.06–5.49) and early mortality (OR 2.85; 95% CI 1.10–7.42). An association with overall mortality was also observed (OR 2.27; 95% CI 0.97–5.27), although this did not reach statistical significance. In time-to-event analyses, patients with elevated hs-cTnT experienced a significantly shorter restricted mean survival time compared with those without hs-cTnT elevation (13.9 vs. 22.4 days), corresponding to a mean survival difference of approximately 8.5 days (95% CI -11.2 to -5.8; p < 0.001).

Conclusion

Admission elevated high-sensitivity cardiac troponin T was associated with adverse outcomes in acute primary intracerebral hemorrhage and showed a notable association with early mortality.