Strokes are life-changing events that can cause a myriad of issues even after it is over. Plenty of tests, such as the national institute of health stroke scale (NIHSS), can gauge the severity of a stroke and predict the severity of the after-effects. Most of these tests use clinical indicators to generate prognosis, but no test utilizes biomarkers.
A team from the Seoul National University College of Medicine wanted to remedy that using the protein serum cardiac troponin 1. Troponin 1 is a protein involved in muscle contraction in the heart and is already a prognostic biomarker for heart attacks. The team specifically wanted to know if it could predict early neurological deterioration after a stroke.
Early neurological deterioration is when a patient experiences damage to neurological function after a stroke. To test this, they pulled data from over a thousand patients and examined several clinical and biological indicators, including troponin 1. Overall, they found that early neurological deterioration was associated with age, not using anti-coagulants, a high NIHSS score, and increased troponin levels. The NIHSS score is usually a good indicator of a good or poor prognosis after stroke. Further analysis showed that troponin levels and NIHSS scores were positively associated, giving more support for troponin 1 as a prognostic biomarker.
The study found that if troponin 1 levels were above a certain threshold in the blood (0.03ng/ml), there was an increased risk of neurological deterioration, while troponin levels below the threshold predicted a much lower risk. This observation could even predict neurological deterioration at low NIHSS scores, where NIHSS had a more favorable prognosis. It did not have enough evidence to be used as a solo marker but has the potential to be used in combination with clinical indicators already in place.
Biomarkers have been a significant area of research in recent years, with many useful biomarkers for cancer and other diseases identified every year. Cardiovascular biomarkers have been more of a challenge to identify, but troponin 1 has shown itself to be a great indicator of prognosis after a stroke or heart attack. This study showed troponin 1 could even be used to predict neurological damage, which could help patients and doctors get ahead of the problem faster than with clinical indicators alone.
The study concludes, “even slight increases in cTnI should be cautiously interpreted and the patients need close observation. However, our insights must be validated with further large, prospective studies.”
Sources: Nature Scientific Reports, Duke Clinical Research Institute
