Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome
BackgroundIschemic stroke (IS) causes significant death and disability. Stroke-Heart Syndrome (SHS) involves cardiovascular complications, worsening outcomes. Diabetes mellitus (DM) increases the risk of myocardial injury following IS. This study explores risk factors for myocardial injury in acute...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Stroke |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fstro.2025.1617937/full |
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| author | Huijuan Pu Yumin Wang Guoping Zhao Binbing Shi Ni An Changxi Zhang Jie Liu Wanling Wu Hong Zhu Lei Li Defeng Pan |
| author_facet | Huijuan Pu Yumin Wang Guoping Zhao Binbing Shi Ni An Changxi Zhang Jie Liu Wanling Wu Hong Zhu Lei Li Defeng Pan |
| author_sort | Huijuan Pu |
| collection | DOAJ |
| description | BackgroundIschemic stroke (IS) causes significant death and disability. Stroke-Heart Syndrome (SHS) involves cardiovascular complications, worsening outcomes. Diabetes mellitus (DM) increases the risk of myocardial injury following IS. This study explores risk factors for myocardial injury in acute ischemic stroke (AIS) with DM patients to improve early identification and prevention.MethodsThis is a retrospective cohort study. Inclusion criteria: neuroimaging-confirmed AIS, admission within 72 h, and measured cardiac troponinT (cTnT) levels. Exclusion criteria included acute hemorrhagic stroke, other cTnT elevation causes, severe organ failure, infections, malignancies, and missing data. Logistic and LASSO regression analyses identified independent risk factors for myocardial injury.ResultsMyocardial injury occurred in 194 patients. Independent risk factors identified were coronary heart disease (CHD), insular cortex lesions, peak brain natriuretic peptide precursor (peak NT-proBNP), C-reactive protein (CRP), and higher National Institutes of Health Stroke Scale (NIHSS) scores. These factors were significantly associated with myocardial injury and ROC analysis showed that the AUC for CHD was 0.621, the AUC for insular cortex lesions was 0.648, the AUC for NIHSS score was 0.726, the AUC for peak NT-proBNP was 0.816 and the AUC for CRP was 0.764. Subgroup analysis suggested that reperfusion therapy was associated with increased myocardial injury risk in various patient subgroups.ConclusionCHD, insular cortex lesions, peak NT-proBNP and CRP levels, and higher stroke severity (NIHSS score) are significant risk factors for myocardial injury in AIS patients with DM. |
| format | Article |
| id | doaj-art-e1b60b62318b414eb19b72e38d259929 |
| institution | Kabale University |
| issn | 2813-3056 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Stroke |
| spelling | doaj-art-e1b60b62318b414eb19b72e38d2599292025-08-20T03:25:29ZengFrontiers Media S.A.Frontiers in Stroke2813-30562025-07-01410.3389/fstro.2025.16179371617937Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndromeHuijuan Pu0Yumin Wang1Guoping Zhao2Binbing Shi3Ni An4Changxi Zhang5Jie Liu6Wanling Wu7Hong Zhu8Lei Li9Defeng Pan10Department of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Geriatric Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of General Practice, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaBackgroundIschemic stroke (IS) causes significant death and disability. Stroke-Heart Syndrome (SHS) involves cardiovascular complications, worsening outcomes. Diabetes mellitus (DM) increases the risk of myocardial injury following IS. This study explores risk factors for myocardial injury in acute ischemic stroke (AIS) with DM patients to improve early identification and prevention.MethodsThis is a retrospective cohort study. Inclusion criteria: neuroimaging-confirmed AIS, admission within 72 h, and measured cardiac troponinT (cTnT) levels. Exclusion criteria included acute hemorrhagic stroke, other cTnT elevation causes, severe organ failure, infections, malignancies, and missing data. Logistic and LASSO regression analyses identified independent risk factors for myocardial injury.ResultsMyocardial injury occurred in 194 patients. Independent risk factors identified were coronary heart disease (CHD), insular cortex lesions, peak brain natriuretic peptide precursor (peak NT-proBNP), C-reactive protein (CRP), and higher National Institutes of Health Stroke Scale (NIHSS) scores. These factors were significantly associated with myocardial injury and ROC analysis showed that the AUC for CHD was 0.621, the AUC for insular cortex lesions was 0.648, the AUC for NIHSS score was 0.726, the AUC for peak NT-proBNP was 0.816 and the AUC for CRP was 0.764. Subgroup analysis suggested that reperfusion therapy was associated with increased myocardial injury risk in various patient subgroups.ConclusionCHD, insular cortex lesions, peak NT-proBNP and CRP levels, and higher stroke severity (NIHSS score) are significant risk factors for myocardial injury in AIS patients with DM.https://www.frontiersin.org/articles/10.3389/fstro.2025.1617937/fullstroke-heart syndromeacute ischemic strokediabetes mellitusmyocardial injuryrisk factors |
| spellingShingle | Huijuan Pu Yumin Wang Guoping Zhao Binbing Shi Ni An Changxi Zhang Jie Liu Wanling Wu Hong Zhu Lei Li Defeng Pan Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome Frontiers in Stroke stroke-heart syndrome acute ischemic stroke diabetes mellitus myocardial injury risk factors |
| title | Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome |
| title_full | Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome |
| title_fullStr | Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome |
| title_full_unstemmed | Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome |
| title_short | Identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus: a retrospective cohort study on stroke-heart syndrome |
| title_sort | identification of risk factors for myocardial injury in acute ischemic stroke with diabetes mellitus a retrospective cohort study on stroke heart syndrome |
| topic | stroke-heart syndrome acute ischemic stroke diabetes mellitus myocardial injury risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fstro.2025.1617937/full |
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