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Updated: Nov 24, 2025

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
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Neurological update: use of cardiac troponin in patients with stroke

Jan F Scheitz1,2,3,4, Helena Stengl5,6,7, Christian H Nolte5,6,8,7

  • 1Klinik für Neurologie mit Experimenteller Neurologie, Charité-Universitätsmedizin Berlin, Berlin, Germany. jan.scheitz@charite.de.

Journal of Neurology
|December 29, 2020
PubMed

Insights

Elevated cardiac troponin after acute ischemic stroke indicates myocardial injury, often linked to poor outcomes. Understanding

Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Cardiac troponin is a key biomarker for myocardial injury.
  • Myocardial injury is common after acute ischemic stroke and predicts worse outcomes.
  • Elevated troponin post-stroke has various causes, including acute coronary syndrome and 'Stroke-Heart Syndrome'.

Purpose of the Study:

  • To review the prognostic implications of elevated cardiac troponin in acute ischemic stroke.
  • To explore the underlying mechanisms of myocardial injury following stroke.
  • To discuss optimal management strategies for stroke patients with elevated cardiac troponin.

Main Methods:

  • Literature review of studies on cardiac troponin, acute ischemic stroke, and myocardial injury.
  • Analysis of current understanding of the brain-heart axis in stroke-related cardiac complications.
  • Synthesis of data on differential diagnoses and clinical management.

Main Results:

  • Elevated cardiac troponin after stroke is associated with significant adverse outcomes.
  • The 'Stroke-Heart Syndrome' encompasses cardiac injury, dysfunction, and arrhythmia due to autonomic disturbances.
  • Differential diagnoses for troponin elevation are crucial for appropriate patient management.

Conclusions:

  • Cardiac troponin elevation in acute ischemic stroke requires careful interpretation beyond just acute coronary syndrome.
  • The 'Stroke-Heart Syndrome' concept highlights the complex interplay between brain and heart.
  • Further research is needed to refine management protocols for these patients.

Keywords:
Brain–heart interactionCardiac biomarkerCardiac troponinIschemic strokeMyocardial infarctionMyocardial injuryStroke-heart-syndrome

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