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Determinants of high sensitivity cardiac troponin T elevation in acute ischemic stroke

Kashif Waqar Faiz1, Bente Thommessen, Gunnar Einvik

  • 1Institute of Clinical Medicine, University of Oslo, Oslo, Norway. kashif.faiz@medisin.uio.no.

BMC Neurology
|June 3, 2014
PubMed

Insights

Elevated cardiac troponin in acute ischemic stroke patients is common, linked to heart disease risk factors and poor outcomes. Acute myocardial infarction may be underdiagnosed in these patients.

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Elevated cardiac troponin and ECG changes occur in acute ischemic stroke, but the cause is often unclear.
  • Investigating the frequency, determinants, and impact of high-sensitivity cardiac troponin T (hs-cTnT) elevation in acute ischemic stroke is crucial.

Purpose of the Study:

  • To determine the frequency of hs-cTnT elevation in acute ischemic stroke patients.
  • To identify factors associated with hs-cTnT elevation and ECG changes.
  • To assess the impact of hs-cTnT elevation on in-hospital mortality.

Main Methods:

  • Retrospective analysis of patients diagnosed with acute ischemic stroke over one year.
  • Exclusion of patients with acute myocardial infarction within seven days prior to admission or during hospitalization.
  • Assessment of hs-cTnT levels, ECG findings, and in-hospital mortality.

Main Results:

  • Over half (54.4%) of 287 patients had elevated hs-cTnT.
  • Independent predictors of hs-cTnT elevation included older age, prior coronary heart disease (CHD), congestive heart failure, diabetes mellitus, and lower estimated glomerular filtration rate (eGFR).
  • A small proportion (6.6%) met criteria for acute myocardial infarction (MI) based on dynamic hs-cTnT changes and ECG findings; dynamic and absolute hs-cTnT changes correlated with higher mortality.

Conclusions:

  • Established CHD and cardiovascular risk factors are linked to hs-cTnT elevation in acute ischemic stroke.
  • Acute MI may be underdiagnosed in patients with acute ischemic stroke.
  • Dynamic changes in hs-cTnT levels indicate a poorer short-term prognosis.
Abstract

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