{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:31:32Z","timestamp":1790364692723,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,9,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Our aim was to determine whether patients with embolic strokes of undetermined source (\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              ) have higher rates of elevated troponin than patients with noncardioembolic strokes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              CAESAR (The Cornell Acute Stroke Academic Registry) prospectively enrolled all adults with acute stroke from 2011 to 2014. Two neurologists used standard definitions to retrospectively ascertain the etiology of stroke, with a third resolving disagreements. In this analysis we included patients with\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              and, as controls, patients with small\u2010 and large\u2010artery strokes; only patients with a troponin measured within 24\u00a0hours of stroke onset were included. A troponin elevation was defined as a value exceeding our laboratory's upper limit (0.04\u00a0ng\/mL) without a clinically recognized acute\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              \u2010segment elevation myocardial infarction. Multiple logistic regression was used to evaluate the association between troponin elevation and\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              after adjustment for demographics, stroke severity, insular infarction, and vascular risk factors. In a sensitivity analysis we excluded patients diagnosed with atrial fibrillation after discharge. Among 512 patients, 243 (47.5%) had\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              , and 269 (52.5%) had small\u2010 or large\u2010artery stroke. In multivariable analysis an elevated troponin was independently associated with\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              (odds ratio 3.3; 95% confidence interval 1.2, 8.8). This result was unchanged after excluding patients diagnosed with atrial fibrillation after discharge (odds ratio 3.4; 95% confidence interval 1.3, 9.1), and the association remained significant when troponin was considered a continuous variable (odds ratio for log[troponin], 1.4; 95% confidence interval 1.1, 1.7).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Elevations in cardiac troponin are more common in patients with\n              <jats:styled-content style=\"fixed-case\">ESUS<\/jats:styled-content>\n              than in those with noncardioembolic strokes.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.005905","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T00:12:00Z","timestamp":1506125520000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Association Between Troponin Levels and Embolic Stroke of Undetermined Source"],"prefix":"10.1161","volume":"6","author":[{"given":"Alexander E.","family":"Merkler","sequence":"first","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino","family":"Gialdini","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh B.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setareh","family":"Salehi Omran","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Moya","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY"},{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Lerario","sequence":"additional","affiliation":[{"name":"Department of Neurology, Weill Cornell Medicine New York\u2010Presbyterian Queens, Flushing, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Neurology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Okin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan W.","family":"Weinsaft","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Weill Cornell Medicine, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika 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