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Troponin elevation in acute ischemic stroke (TRELAS)--protocol of a prospective observational trial

Jan F Scheitz1, Hans-Christian Mochmann, Christian H Nolte

  • 1Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany. jan-friedrich.scheitz@charite.de

BMC Neurology
|August 10, 2011
PubMed

Insights

Elevated cardiac troponin T (cTnT) in acute ischemic stroke patients is common. The TRELAS study investigates its cause to guide clinical management and improve patient outcomes.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Elevated cardiac troponin T (cTnT) is frequent in acute ischemic stroke (AIS) and predicts poor outcomes.
  • The cause of cTnT elevation in AIS is uncertain, potentially due to co-morbid coronary artery disease or neurogenic cardiac damage.
  • This uncertainty complicates the diagnostic and therapeutic management of AIS patients with elevated cTnT.

Purpose of the Study:

  • To investigate the frequency and underlying pathomechanism of cTnT elevation in AIS patients.
  • To provide guidance for clinical practice regarding the workup of AIS patients with elevated cTnT.
  • To clarify the pathophysiologic concepts of co-morbid cardiac damage in AIS.

Main Methods:

  • Prospective observational trial (TRELAS) screening AIS patients for cTnT elevation.
  • cTnT levels measured on admission and the following day; elevated levels trigger coronary angiography within 72 hours.
  • Comparison of angiographic findings with matched Non-ST-Elevation myocardial infarction patients to identify obstructive coronary artery disease.

Main Results:

  • The study aims to determine the primary endpoint: occurrence of culprit lesions in coronary angiograms indicating obstructive coronary artery disease.
  • Secondary endpoints include stroke localization and cardiac dysfunction suggestive of stroke-induced damage.
  • The findings will establish the frequency and etiology of cTnT elevation in AIS.

Conclusions:

  • The TRELAS study will prospectively determine the frequency and etiology of troponin elevation in a large AIS cohort.
  • Findings are expected to clarify pathophysiologic concepts of cardiac damage in AIS.
  • Results will provide a basis for clinical recommendations for cardiac workup in AIS patients.
Abstract

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