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Related Concept Videos

Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
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Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

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Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
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Rising Cardiac Troponin: A Prognostic Biomarker for Mortality After Acute Ischemic Stroke.

Michela Rosso1, Srinath Ramaswamy2, Yohannes Mulatu3

  • 1Department of Neurology University of Pennsylvania Philadelphia PA USA.

Journal of the American Heart Association
|February 13, 2024
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A rising cardiac troponin (cTn) pattern in acute ischemic stroke (AIS) patients indicates a higher risk of mortality and poor outcomes. This dynamic change, unlike stable levels, signals acute cardiac issues and warrants closer monitoring.

Keywords:
cardiac complicationscardiac troponininsulaischemic strokemortality

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Area of Science:

  • Cardiology
  • Neurology
  • Biomarkers

Background:

  • Elevated cardiac troponin (cTn) is common in acute ischemic stroke (AIS), affecting 10-30% of patients and correlating with poor outcomes.
  • Serial cTn measurements distinguish dynamic patterns (rise/fall >20%) indicating acute myocardial injury from nondynamic patterns attributed to chronic conditions.

Purpose of the Study:

  • To investigate the impact of the direction of cardiac troponin (cTn) change—rising versus falling—on mortality and functional outcomes in patients with acute ischemic stroke (AIS).

Main Methods:

  • Retrospective analysis of 300 patients with AIS and elevated cTn from 5 stroke centers, with serial measurements within 48 hours.
  • Categorization of cTn patterns into rising (>20% increase), falling (>20% decrease), or nondynamic (≤20% change).
  • Logistic regression used to assess associations between cTn patterns and 7-day mortality and unfavorable discharge disposition.

Main Results:

  • A rising cTn pattern was observed in 72 patients, falling in 66, and nondynamic in 162.
  • Acute myocardial infarction was diagnosed in 54% of patients with rising cTn versus 33% with falling cTn (P<0.01).
  • Rising cTn independently associated with higher 7-day mortality (aOR=32) and unfavorable discharge disposition (aOR=2.5) compared to nondynamic patterns.

Conclusions:

  • A rising cardiac troponin (cTn) pattern in patients with acute ischemic stroke (AIS) is an independent predictor of increased mortality.
  • Rising cTn levels are also significantly associated with unfavorable discharge disposition in AIS patients.