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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Cardio-protection in acute stroke

Jagdish C Sharma1, Ian Ross, Michael Vassallo

  • 1Kings Mill Hospital, Sutton in Ashfield, Notts NG17 4JL, UK. jagdish.sharma@sfh-tr.nhs.uk

International Journal of Stroke : Official Journal of the International Stroke Society
|August 19, 2008
PubMed

Insights

Protecting the heart in acute stroke patients may reduce mortality. Elevated cardiac biomarkers like NT-proBNP indicate heart risk and higher mortality, suggesting therapeutic interventions are warranted.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Context:

  • Acute stroke mortality remains a significant concern despite existing damage limitation strategies.
  • Cardiovascular factors, including cardiac impairment and injury, play a critical role in acute stroke outcomes.
  • The neurohumoral response in stroke can lead to cardiac stress and damage.

Purpose:

  • To review the influence of cardiovascular factors, specifically NT-proBNP, on stroke mortality.
  • To evaluate the prognostic value of cardiac biomarkers in acute stroke patients.
  • To explore potential therapeutic strategies targeting cardiac protection in stroke.

Summary:

  • Cardiovascular abnormalities, evidenced by ECG changes, tachycardia, and elevated cardiac biomarkers (Troponin, NT-proBNP), are associated with increased mortality in acute stroke.
  • NT-proBNP levels are particularly significant, showing a strong correlation with short- and long-term mortality, sometimes exceeding the predictive power of clinical stroke severity.
  • Neurohumoral activation and Renin-Angiotensin-Aldosterone-System (RAAS) changes in stroke contribute to cardiac stress, but also present potential targets for cardioprotective therapies.

Impact:

  • Identifying occult cardiac damage in stroke patients is crucial for understanding mortality.
  • Investigating cardioprotective interventions, using existing or novel drugs (e.g., beta-blockers, RAAS inhibitors), could significantly reduce stroke-related deaths.
  • This research highlights the critical brain-heart axis and the potential for a broad therapeutic window for cardiac interventions in acute stroke management.
Abstract

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