Frequency and outcome of elevated troponin level in patients presenting with acute ischemic stroke at a tertiary care hospital, Karachi

Background: Heart troponin has been observed to be raised in patients with acute ischemic stroke (AIS); its prognosis is controversial. The aim of this study was to review the incidence of raised troponin levels and the correlation between raised troponin and 90-day mortality in AIS. Objective: To determine the frequency of elevated cardiac troponin levels among patients presenting with acute ischemic stroke at a tertiary care hospital in Karachi and to evaluate the association between elevated cardiac troponin levels and clinical outcomes in these patients. Methods: This prospective observational cohort study was carried out from March 2025 to November 2025 at medicine department of Aga Khan University Hospital, Karachi, involving 155 AIS patients. All patients had a blood sample taken for measurement of troponin within 24 hours of admission. The patients were classified according to troponin status and demographic; clinical and outcome data were analyzed. A data collection proforma was used to gather the data of 155 patients who were admitted with an acute ischemic stroke (AIS) at Aga Khan University Hospital. Levels of serum troponin were measured, and 90-day mortality was evaluated. Data were summarized using descriptive statistics (mean, median and percentages). Inferential analysis (chi-square/Fisher's exact) was used to assess association between troponin levels and outcome. Results: 36.1% had elevated troponin. The elevated-troponin group had a significantly higher 90-day mortality rate than the normal-troponin group, 21.4% vs. 4.0% (p = 0.0015). Conclusion: Elevation of troponin is frequent in AIS and is a strong predictor of the 90-day mortality, suggesting that troponin is a useful tool to be used to stratify the risks early on in AIS.